NHS Urgent Medicine Supply Advanced Service (NUMSAS) – FAQs

NHS Urgent Medicine Supply Advanced Service (NUMSAS) – FAQs

This page contains Frequently Asked Questions (FAQs) on the NHS Urgent Medicine Supply Advanced Service (NUMSAS) – last updated on 30th November 2016. 

Background and general

Q.Is it compulsory to provide this service?

No. NUMSAS is an Advanced Service in the Community Pharmacy Contractual Framework so contractors can choose whether they wish to provide this service.

Q. Can distance selling pharmacies provide the NUMSAS?

Yes. A distance selling pharmacy may provide Advanced and Enhanced Services, as long as any Essential Service which forms part of the Advanced or Enhanced Service is not provided to persons present at the premises. The distance selling pharmacy must fully meet the requirements for the provision of the NUMSAS, which includes the consultation room requirements.

Q. Can pharmacies in Wales provide the NUMSAS?

The new Advanced Service only applies to England; Community Pharmacy Wales undertakes separate negotiations on Advanced Services which are provided in Wales. 

Commissioning and service requirements

Q. How do contractors inform NHS England that they intend to provide the NUMSAS?

Contractors must notify NHS England that they intend to provide the service via a declaration on the NHS BSA website.

The electronic form on the NHS BSA website asks for the Pharmacy Organisation Code; this is the ODS or F code for the pharmacy that is used on the end of month submission to the Pricing Authority. If the form is incorrectly completed it may result in non-payment for the service.

Q. Does the notification of NHS England of a pharmacy contractor’s intention to start providing the service (via the form on the NHS BSA website) need to be undertaken for each pharmacy a contractor owns?

Yes. The notification may be undertaken centrally by one person on behalf of the contractor, but a notification needs to be made for each individual pharmacy that will be providing the service.

Q. Does the notification to NHS England of intent to provide the service have to be made for each pharmacist that will provide the service?

No. The notification is only required for each pharmacy.

Q. Will the service be commissioned on an ongoing basis?

This is currently unknown as the pilot is only commissioned until 31st March 2018. As with any service commissioned by the NHS, it will be necessary to demonstrate that the service is offering value for money and having a positive impact on patient care. An evaluation of the service will be undertaken as part of the pilot and this will be used to help demonstrate the value of the service.

Q. What is the length of time that the service is commissioned for?

The Urgent Medicine Supply Service commenced on 1st December 2016 and will run until 31st March 2018.

Q. Will the service be evaluated?

Yes. NHS England will commission an evaluation as part of the pilot.

Q. How will NHS England evaluate the service?

NHS England will use service information provided by contractors, information gathered from completed patient questionnaires and other data to evaluate the service.

Q. I am an LPS contractor. Will I be able to provide the NUMSAS?

All the services to be provided by an LPS contractor must be agreed between NHS England and the pharmacy and be included in the LPS contract. If LPS contractors want to provide the service, they should contact their local NHS England team to propose a contract variation, to include an Urgent Medicine Supply Service.  The location of the ‘essential small pharmacy’ LPS premises often in areas where there are no other healthcare providers could provide a very convenient service for the public who would otherwise be hard to reach. 

Q. An Emergency Supply Service is already commissioned from community pharmacies in my area. What will happen to that service?

Many LPCs have managed to persuade local commissioners to commission such a service in their area and many of these services also have a wider scope beyond patients referred directly by NHS 111. This approach provides a more coherent community pharmacy solution to the challenges that urgent care services are facing, and PSNC has sought to persuade NHS England that a service with a wider scope would deliver greater value to patients and the NHS. NHS England has, however, remained adamant that the scope of the service can only cover patients referred directly by NHS 111.

PSNC has advised LPCs that have emergency supply services commissioned in their area that they may wish to discuss the commissioning of the national service with their local commissioners, to ensure they understand the restricted scope of the proposed national service.

Where a locally commissioned service is currently only focussed on referrals from NHS 111, PSNC has advised LPCs that they may want to propose to the commissioner that at the point the national service is implemented, the scope of the locally commissioned service could be changed to focus on patients self-presenting in pharmacies or being referred directly via other healthcare providers.

Clearly it will be important that in due course there are detailed local discussions on the transition from any local NHS 111 focussed service to the national service and PSNC will push NHS England to issue guidance to commissioners on the issues that need to be considered at a local level.

Premises requirements

Q. My pharmacy doesn’t have a consultation room; can I provide the service? No. Having a consultation room is a prerequisite for provision of the NUMSAS. The consultation room, which can be used to consult with the patient or patient’s representative, must comply with the minimum requirements set out below:

  • the consultation room must be clearly designated as an area for confidential consultations;
  • it must be distinct from the general public areas of the pharmacy premises; and
  • it must be a room where both the person receiving services and the pharmacist providing those services are able to sit down together and talk at normal speaking volumes without being overheard by any other person (including pharmacy staff), other than a person whose presence the patient requests or consents to (such as a carer or chaperone).

 The consultation room must also meet the General Pharmaceutical Council (GPhC) Standards for Registered Premises.

Eligible patients

Q. Is this service available to patients that self-present to the pharmacy requesting an emergency supply?

No. This service is only available to patients who have been referred to the pharmacy from NHS 111. No payments will be made under this service for medicines or appliances supplied to walk-in patients who have not been referred by NHS 111.

Q. Are patients who are not prescription-exempt eligible for this service?

Yes. Patients who are not prescription-exempt are eligible to access this service; NHS prescription charges would be collected as normal.

Q. Are housebound patients eligible for this service?

Yes. The pharmacist can interview the patient on the telephone to assess whether it is appropriate to make an emergency supply.  However, if a patient is housebound and therefore unable to visit the pharmacy, the pharmacist should use their professional judgement as to whether it is appropriate for a representative to collect the medication or appliance on the patient’s behalf.

Practicalities of service provision

Referrals from NHS 111

Q. Will the NHS 111 call handler assess the patient to determine if an emergency supply is appropriate?

No. The NHS 111 call handler will advise patients that the pharmacist may decide to make a supply of the medicine or appliance required, but the supply will only be made at the professional discretion of the individual pharmacist.

Q. How often should we be checking NHSmail for NHS 111 referrals?

NHS England has advised that NHSmail must be ‘regularly’ checked, especially within traditional out of hours periods such as weekday evenings, weekends and holidays, to pick up referrals from NHS 111 in a timely manner. This should include when a pharmacy opens and before the pharmacy closes each day.

‘Regularly’ has not been defined by NHS England in the service specification, therefore it is up to the contractor to determine the appropriate intervals.

Telephone call between the patient and pharmacist

Q. Can a pharmacy staff member conduct the telephone call with the patient?

No. Since the call involves assessing the patient’s suitability for a supply of a medicine or appliance, the telephone call must take place between the pharmacist and the patient.

Q. If we do not have an item in stock and we refer the patient to another pharmacy, are we still able to claim for the Consultation and Administration fees?

Yes.

Q. If, during the telephone consultation I determine that it is not possible to make a supply to a patient, who should sign the reverse of the FP10DT EPS dispensing token?

If a supply of a medicine or appliance is not made, the reverse of the FP10DT EPS dispensing token does not need to be signed.

Summary Care Record (SCR)

Q. Does the pharmacy need to be SCR enabled to provide this service?

No. However, the patient’s SCR can be a useful decision making aid to check a patient’s previous prescription history and whether a prescription for the urgently requested medicine or appliance has recently been issued by the patient’s GP. The SCR should only be checked if it is appropriate to do so and with the patient’s consent. PSNC recommends that all pharmacy contractors should ensure they have access to the SCR.

Q. Does verbal consent to check the patient’s SCR over the telephone meet the consent requirements for accessing SCR?

Yes.

Q.How does a pharmacy become SCR enabled?

Please refer to PSNC’s page on preparing for SCR.

Supply

Q. Does this service only allow prescription only medicines (POMs) to be supplied?

No. The service allows the supply of all medicines and appliances that can be supplied on an NHS prescription, in line with the provisions of the Human Medicines Regulations.

 Q. How many days’ worth of treatment can be supplied?

The pharmacist should apply their professional judgement to determine the most appropriate length of treatment to supply, in line with the provisions of the Human Medicines Regulations.

Q. Is there a maximum number of times that a patient can use the service?

No. The pharmacist should apply their professional judgement to determine the appropriateness of supply each time a patient is referred, in line with the provisions of the Human Medicines Regulations.

Q. Is there a maximum number of medicines or appliances that can be supplied as part of the service?

No. The pharmacist should apply their professional judgement to determine the appropriateness of supply of each requested medicine or appliance, in line with the provisions of the Human Medicines Regulations.

Service promotion

Q. Can we promote the service to patients?

No. This service should not be promoted to the public by either the pharmacy staff or the NHS to ensure that it is only used by patients for urgent cases and not as a replacement for the normal repeat prescription ordering and repeat dispensing processes.

Records and documentation

Q. Can we make a supply if a patient does not provide evidence of exemption entitlement?

Yes. Where a patient is unable to provide evidence of their exemption from NHS prescription charges, the contractor should record this on the FP10DT EPS dispensing token. NHS England may make checks on patients’ claims to entitlement of exemption from NHS prescription charges.

Training and other requirements

Q. Is a specific standard operating procedure (SOP) required for the NUMSAS?

Yes.

Q. How does a pharmacy become NHSmail enabled?

Please visit PSNC’s page on NHSmail.

Service availability

Q. Is this service only available out of hours i.e. evenings, weekends and bank holidays (when GP surgeries are closed)?

No. The service must be available throughout the opening hours of the pharmacy (both core and supplementary hours).

Q. The service specification states that the contractor must ensure that the service is available throughout the pharmacy’s core and supplementary opening hours – does this mean that locum pharmacists that I book to work in my pharmacy must be able to provide this service?

Yes. Once a contractor starts to provide the service they must ensure that the service is available throughout the pharmacy’s contracted opening hours. Therefore, contractors should seek to book locum pharmacists who can provide the NUMSAS.

Data recording and reporting

Q. Is there national paperwork/forms for the service?

Yes. National paperwork has been developed to notify the patient’s GP practice of the supply of medicine or appliance and a patient questionnaire is also available. These forms can be downloaded from the NUMSAS hub on the PSNC website.

Q. Must patient consent be recorded in writing?

No. NHS 111 will obtain patient consent for receiving the service and for the pharmacy sharing information with the patient’s GP practice, NHS England and the NHS Business Services Authority.

Q. Does the patient’s GP practice always need to be informed if a medicine or appliance has been supplied to the patient?

Yes. The requirement is that a notification of the medicine or appliance supplied is sent to the patient’s GP practice on the same day the medicine or appliance is supplied or on the following working day.

 Q. If a web-based platform such as Sonar or PharmOutcomes is available in my area for the NUMSAS, do I have to use it?

PSNC would strongly encourage the use of web-based platforms, such as Sonar or PharmOutcomes if they are available in your area as this means that the local NHS England team and/or the LPC will be able to access local data to monitor uptake of the service. It also means the GP notification form can be sent electronically, taking away the need to print out a GP notification form and deliver or fax to the GP surgery.

Q. Will NHS England provide IT support for recording and claiming for provision of the service?

No national IT support will be provided by NHS England to support provision of the service. If at a local level, IT systems are available that allow the notification of a patient’s GP practice to take place electronically, these may be used.

Training and competency requirements

Q. Are there specific training requirements for this service?

The necessary knowledge and skills to provide the service should be a core competency for all pharmacists. Pharmacists will want to ensure they have an up to date understanding of the Human Medicines Regulations in relation to the emergency supply of prescription only medicines. The Royal Pharmaceutical Society’s guidance on emergency supply and the Urgent care: a focus for pharmacy distance learning from CPPE may also provide useful knowledge to support provision of the service.  

The contractor must ensure that all pharmacy staff involved in provision of the service are appropriately trained on the operation of the service, including relevant sections of the standard operating procedure.

Funding and payment claims

Q. How do I claim payment for provision of the NUMSAS?

Contractors must complete the NHS Urgent Medicine Supply Advanced Service Claim submission form at the end of each month and submit this to the Pricing Authority. Please note, this cannot be sent as part of the end of month prescription bundle, as the submission form needs to be sent to a different address.

Q. Can we submit the NHS Urgent Medicine Supply Advanced Service Claim submission form as part of the monthly prescription bundle?

No. This process will be separate to the submission of other FP10 forms and the form needs to be sent to a different address.

Q. If I send my claims form to the NHS BSA a month later than the medicines or appliances were supplied will I still get paid (provided I have sent them before the March 2018 submission date when the service finishes)?

Claims should be sent immediately following the months they correspond to; otherwise contractors are at risk of not getting paid.

Q. If it is not possible to make a supply due to prohibitions within the legislation or other patient factors, are we still able to claim the Consultation and Administration fees?

Yes.

Q. Will my pharmacy be sent paperwork for the service or do I need to download this from the PSNC website?

The forms will need to be downloaded from the PSNC or NHS BSA (for the claim form) websites.

Q. Can I make claims for payment via PharmOutcomes or Sonar instead of using the claim form and sending it to the Pricing Authority?

No.

Q. Where is the money for the service coming from?

Money from the Pharmacy Integration Fund is being used to test and evaluate the national pilot of the service. 

Q. How much money is available the fund the service?

NHS England has budgeted £2 million for the pilot based on NHS 111 call volumes and estimated referral rates.

Patient questionnaire

Q. What is the website address for the patient questionnaire IT platform?

NHS England has not yet provided the website address for the patient questionnaire IT platform.

Q. Is it a requirement to upload all questionnaire results electronically if captured via paper?

When patient questionnaires are completed on paper, contractors should utilise the functionality available on the IT platform to submit patients’ responses to the questionnaire.

Q. Do all patients have to be asked to complete the patient questionnaire following the supply of a medicine or appliance? Yes. Patients should be encouraged to complete the questionnaire, but they have the right to refuse to do so.

Q. What will the NHS England patient questionnaire website support contractors and patients to do?

The website is expected to support several functions, including allowing patients to complete the questionnaire online and allowing pharmacy teams to collate the results of completed paper questionnaires returned to them by patients. Patients will also be able to access and complete the questionnaire via a QR code if the patient has a smart phone with a QR code reader App installed on it. Further details on the website will be made available by NHS England in due course.

Return to the Urgent Medicine Supply Service hub page



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