Items With Multiple Flavours

Items With Multiple Flavours

Prescriptions containing items available with multiple flavours  can be prescribed in different ways. This page goes through the different scenarios of how prescribers will send prescriptions to pharmacy teams and how pharmacy teams should dispense and endorse them as well as covering how pharmacy contractors will be paid in these scenarios.

Prescriptions for multiple flavours also need to be endorsed correctly to ensure reimbursement for the appropriate number of Single Activity Fees (SAF), the SAF is paid automatically for all eligible items and, where a prescription orders multiple, assorted, various or mixed flavours, one SAF can be claimed for each flavour supplied and endorsed. You can read more about the SAF in our factsheet here

The request to dispense multiple flavours can be expressed in different ways and the table below shows how the NHS Business Services Authority (NHSBSA) treats the information.

The table below shows some examples from EPS and paper prescriptions and the fees that would apply.

Example reference below Prescribed field information EPS Paper
1 Flavour specified e.g. ‘Vanilla’ ‘Fortisip  Bottle Vanilla (Nutricia Ltd)’ Only one fee is paid per flavour specified Only one fee is paid per flavour specified
2 ‘Flavour Not Specified’
‘Fortisip Bottle (Flavour Not Specified)’
Where flavoured products are prescribed, and the prescriber does not want to specify the flavour required to allow the patient or pharmacist to choose instead, the ‘Flavour Not Specified’ option can be selected.
Unless ‘AF’ endorsement is selected by the prescriber, only one fee per item is paid regardless of how many flavours are endorsed. Only one fee is paid regardless of how many flavours are endorsed. However, see point 4.
3 Mixed/assorted/various flavours
‘Fortisip Bottle (Nutricia Ltd) (Flavour Not Specified)
Multiple Flavours’
The prescriber must add the ‘AF’ endorsement in the prescriber
endorsement field if the patient requires multiple flavours.
A fee is paid for each flavour endorsed. For example, six
different flavours endorsed would attract six fees.
4 Supplementary information in dosage/directions
‘Fortisip Bottle (Nutricia Ltd) (Flavour Not Specified)
One to be taken twice daily (Strawberry and Banana)’
If the prescriber has added assorted, mixed or various flavours to the dosage instructions of an EPS prescription, this will not be seen by NHSBSA as they only extract prescriber endorsements (for example, ‘AF’) from the prescriber endorsement field of the EPS prescription message. If supplementary information requesting various flavours is added to the dosage/directions area, the prescription will need to be placed in a red separator to be seen by an operator if multiple flavours are endorsed

EPS Prescriptions

Paper Prescriptions

Prescription charges and fees

If a patient is not exempt from prescription charges, and multiple flavours of the same product are prescribed as separate items, only one prescription charge would apply.

PSNC Top Tips: 

  • If the prescriber orders mixed or assorted flavours then it is best practice to endorse exactly which flavours you have given as opposed to the number of different of flavours you have used e.g. ‘6 x 250ml vanilla; 6 x 250ml coffee’ instead of ‘2 flavours’.
  • It is best practice for pharmacy teams to record the number of items dispensed on the prescription in the box provided in the bottom left hand corner of the paper FP10 prescription. When totalling up your items figures and entering onto your FP34C ensure one item is claimed for each flavour dispensed and endorsed.
  • When checking your Schedule of Payment (SoP) for expensive flavoured products, remember that each flavour is paid separately so may not appear in the list of expensive items breakdown on the SoP unless the cost per individual flavour exceeds £100.
  • EPS prescriptions for flavoured products where the same flavour has been endorsed multiple times only receive one fee regardless of how many times the same flavour is endorsed. The prescription should be endorsed as one entry of the required flavour with details of the appropriate total quantity dispensed.

Click here to see PSNC’s webinar on endorsements which includes information on endorsing multiple flavours ordered on electronic and paper prescriptions. The webinar slides can be viewed here.

Related resources

Multiple flavours factsheet

Dispensing Factsheet: Expensive items

Webinar – Endorsing Good Practice Guidance:How To Avoid Common Errors

Dispensing and Supply Factsheet: Understanding the Single Activity Fee

Special Container Database

Endorsement Guidance


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