Temporary safeguarding payments

Temporary safeguarding payments

Part XIVC of the Drug Tariff sets out the temporary safeguarding payment arrangements put in place where a pharmacy contractor’s dispensing business is adversely affected if prescribers systematically increase prescription duration on all or a significant percentage of their prescription items, due to direct or indirect instigation by the CCG. This could lead to dispensing contractors facing increased supplier bills in certain months (as more medicines are dispensed per prescription than usual) and then decreased prescription item volume in subsequent months.

There are two payments available, depending on the type of claim made:

  • Payment due to an increase in supplier bills following an increase in prescription volume (Claim 1).
  • Payment due to an increase in prescription duration and the subsequent drop in items dispensed and therefore fewer fees (Claim 2).

Claim 1 – To provide support to pay an increase in supplier’s bill

For a month where the prescription item duration has increased compared to that seen previously, as the contractor will have dispensed significantly more medication per prescription item than usual, the 100% advance (which is based on a historic net ingredient cost) is likely to be insufficient to cover the contractor’s supplier bill for the month.

In these circumstances, the contractor is able to claim for that month, for an increase in their 100% advance (Claim 1) via the Pharmacy contractor additional advance/compensatory fee claim form. The amount that can be claimed should reflect the amount by which the contractor’s supplier bill has increased solely due to the increase in prescription item duration and no other reason.

Part XIVC Criteria for an application for Claim 1

The claim will need to:

  • be made on the appropriate form available from the NHS Prescription Services of the NHS Business Services Authority (NHSBSA) or at www.nhsbsa.nhs.uk
  • be signed by the contractor.
  • be submitted to the NHS Prescription Services of the NHSBSA along with their end of month submission form/declaration (FP34C) for that month.
  • include a declaration that to the best of the contractor’s knowledge there is no reason apart from increased prescription duration, directly or indirectly instigated by a CCG, that would have contributed to the larger than normal suppliers bill e.g. not because of a new GP operating in their area who typically prescribes for a longer duration than other local GPs or because the contractor has dispensed higher than usual high cost drug prescription items.
  • be substantiated for example with a copy of the previous three months supplier bills and the current increased bill – or where this is inconclusive, some other rationale.

On receipt of a valid claim at the NHS Prescription Services of the NHSBSA:

  • The contractor will be paid an increase in their 100% advance in line with the claim
  • The increased advance will be taken into account in the usual way the following month when the final accurate payment for the month is paid.

How to complete Temporary Safeguarding Payments claim form for Claim 1

  • Fill in Section A of the claim form titled ‘Additional Advance claim’
  • Claim in respect of prescriptions dispensed in the month of MM/YY – this is the month during which your suppliers bill increased as a result of increased prescription duration. For example a contractor would specify May 2020 if they had a rise in their May 2020 wholesaler bills due to increase in Rx duration,
  • Value of additional advance – This is the amount by which the wholesaler bills have increased. It does not have to be a precise figure but should closely reflect the additional level of Advance payment a contractor is seeking due to increase in wholesaler bills linked to an increase in prescription duration. Any Advance is subsequently recovered by the NHSBSA so this claim is simply to help a contractor manage their cashflow to pay the wholesaler bills until the final balancing payment is made.

For Claim 2 – Remuneration

For the months following an increase in prescription duration, contractors may experience a drop in items dispensed and as a result earn fewer fees.

In these circumstances, the contractor is able to claim for an affected month, for any lost fees and allowances (Claim 2) via the Pharmacy contractor additional advance/compensatory fee claim form.

Part XIVC Criteria for an application for Claim 2

The claim will need to:

  • be made on the appropriate form available from the NHS Prescription Services of the NHSBSA or at www.nhsbsa.nhs.uk.
  • be signed by the contractor.
  • be submitted to the NHS Prescription Services of the NHSBSA along with their end of month submission form/declaration (FP34C) for that month.
  • Include a declaration that to the best of the contractor’s knowledge there is no reason apart from increased prescription duration, directly or indirectly instigated by a CCG, that would have contributed to a decrease in fees earned e.g. a new pharmacy opened nearby.

On receipt of a valid claim at the NHS Prescription Services of the NHSBSA:

  • The contractor will be paid on the volume of prescription items for same month of the previous year, but at the current value of fees and allowances.
  • Where a contractor makes a claim, for the month in which they are claiming they will be paid on the volume of the previous year’s prescriptions regardless of whether this volume is lower than the prescription volume submitted for the month claimed.

How to complete Temporary Safeguarding Payments claim form for Claim 2

  • Fill in Section B of the claim form titled ‘Compensatory fee claim’
  • Claim in respect of prescriptions dispensed in the month of MM/YY – this is the month during which the pharmacy saw a decrease in prescription items, following a month where prescription durations were increased. For example a contractor would specify June 2020 if they had a rise in prescription duration in May subsequently leading to a decrease in prescription items in June.
  • Names of GP practices and their addresses – Enter the name(s) and address(es) of all GP practices who increased the duration of prescriptions.

For Claims 1 and 2, in general

  • Claim 1 would not normally be expected to be made in the same month as Claim 2.
  • Because of the nature of Claim 1 it would not normally be appropriate to claim it in consecutive months, but it may be appropriate to claim it more than once.
  • Typically, Claim 2 would follow a Claim 1, but Claim 2 could be made where a Claim 1 has not been made in a previous month, for example, where prescription duration has increased slowly. In these cases, the usual 100% advance may have been sufficient, but the contractor is experiencing a reduction in fees and allowances for which they wish to claim.
  • Because of the nature of Claim 2, it may be appropriate to claim it in consecutive months, but it is unlikely to be appropriate for it to be claimed every month.

For Claim 1 and 2, in situations where the claim is outside conditions agreed by Department of Health and Social Care (DHSC) and Prescription Services Negotiating Committee (PSNC), the claim will be subject to joint verification by the NHSCB and the contractor’s Local Pharmaceutical Committee (LPC), subject to agreement with the contractor on LPC involvement.

Where a contractor makes one or more valid claims in the previous three months, they will be entitled to an “amendment allowance” of £30 for the quarter (regardless of how many claims made), in recognition of the administrative time required to make claims.

Please read Part XIVC of the Drug Tariff before submitting your claim.


FAQs

Can I make a backdated claim for temporary safeguarding Claim 2?

Temporary safeguarding claims cannot be backdated. The claim form must be submitted to the NHSBSA along with the FP34C for that month.

Our pharmacy has seen a very substantial fall in FP10MDA prescription items due to local policy changes moving from daily to weekly collection. Do the temporary safeguarding payments take this into consideration; including the loss of any Single Activity Fees and Controlled Drug fees?

If a local policy change has led to an increase in prescription durations, and is driven directly or indirectly by the CCG, then you can use the temporary safeguarding payments arrangements to claim for the difference in dispensing fee volumes. You would need to be satisfied that this is the case before making the claim. The temporary safeguarding payment arrangements do not compensate for losses of any other fees such as Controlled Drug fees.
Please note where prescribing intervals have reduced from daily to weekly collection for methadone prescriptions, a pharmacy may be able to claim for supplying daily dispensing bottles (Packaged dose ‘PD’ fee) currently at £0.55 per additional daily bottle of methadone supplied.

 



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