Disallowed EPS items submitted for payment in July 2020

Disallowed EPS items submitted for payment in July 2020

October 16, 2020

In July 2020 (the most recently priced dispensing month), a total of 490 items issued via Electronic Prescription Service (EPS) were returned as disallowed by the NHS Business Services Authority (NHSBSA). The NHSBSA has shared with PSNC a list (see table below) of the top 10 disallowed prescription items submitted for payment via EPS in the dispensing month of July 2020.

Actual Medicinal Product Pack (AMPP) Number of EPS items disallowed in July 2020
Cerumol olive oil ear drops (Thornton & Ross Ltd) 10 ml 136
C-View dressing 6cm x 7cm (Aspen Medical Europe Ltd) 10 dressing 23
Calpol Soothe & Care saline 0.9% nasal drops (McNeil Products Ltd) 10 ml 14
Carmellose 0.5% eye drops (Colorama Pharmaceuticals Ltd) 10 ml 12
C-View dressing 10cm x 12cm (Aspen Medical Europe Ltd) 10 dressing 11
C-View dressing 10cm x 12cm (Aspen Medical Europe Ltd) 1 dressing 10
Water for irrigation 1litre bottles (Baxter Healthcare Ltd) 1 bottle 10
C-View dressing 6cm x 7cm (Aspen Medical Europe Ltd) 1 dressing 10
C-View dressing 12cm x 12cm (Aspen Medical Europe Ltd) 10 dressing 7
Sodium chloride 0.9% nasal drops (Sandoz Ltd) 10 ml 6

Note: C-View dressings item were present within the Part IX of the June 2020 Drug Tariff but were deleted from the July 2020 Drug Tariff

It is interesting to note that the top 10 disallowed products were all appliances that were NOT listed in Part IX of the Drug Tariff and therefore not allowed on an NHS prescription. For advance notice of all the monthly deletions from Part IX, please see the following page Drug Tariff Appliance Watch: Notice of Deletion

Although in majority of cases the disallowed products listed above were prescribed accordingly, in some cases contractors may have inadvertently selected and submitted a disallowed Actual Medicinal Product Pack (AMPP) in the EPS message. If a generically written prescription is received for a product which has several AMPP’s listed on the Dictionary of Medicines and Devices (dm+d), pharmacy contractors should ensure that they select/endorse the correct AMPP that is allowed. If an AMPP is selected for a product that is not allowed on the NHS, the NHSBSA will not reimburse the item.

Some PMR suppliers have made adjustments to their systems to help minimise or remove the risk of users inadvertently dispensing a disallowed drug or appliance, for example, by generating warning prompts when a disallowed product is prescribed/selected. PSNC recommends that EPS suppliers synchronise to dm+d and Drug Tariff changes frequently (note that dm+d is updated weekly by the NHSBSA) to reduce the risks of users inadvertently prescribing/dispensing products that have recently been deleted/amended in the Drug Tariff. EPS users should ensure their systems are kept up to date otherwise systems may not incorporate the latest data available. Read more at dm+d for further information about the database and how suppliers are mapping to it. Information on sharing feedback with your PMR supplier can be viewed here psnc.org.uk/reportIT.

Contractors should contact the NHS Prescription Services Helpdesk (Tel: 0300 330 1349) if an item is believed to have been disallowed in error by the NHSBSA. Alternatively, contractors who have access to view their disallowed items via the Manage Your Service (MYS) dashboard can submit a challenge to the NHSBSA for disallowing an item. If a disallowed item is successfully challenged by a contractor, the NHSBSA will reimburse that item and make a payment adjustment to the contractors account at the earliest opportunity.


Background

The most common reasons why certain items are disallowed on the NHS include where the product is:

  • classed as a drug and included in the list of Drugs, Medicines and Other Substances listed in Part XVIIIA of the Drug Tariff that may not to be ordered under the National Health Service (General Medical Services Contracts) (Prescription of Drugs etc.) Regulations 2004, or
  • an appliance/device not listed in Part IXA, IXB or IXC of the Drug Tariff, or
  • a chemical reagent not listed in Part IXR of the Drug Tariff, or
  • prescribed by a dentist on a FP10D form but the item is not listed in the dental prescribing formulary (Part XVIIA)
  • prescribed by a nurse on a FP10P but the item is not listed in the nurse prescribers’ formulary for community practitioners (Part XVIIB(i))
  • prescribed by a nurse who does not hold the appropriate prescribing qualifications
  • a drug listed in Part XVIIIB or is a vacuum pump or constrictor ring listed in Part IXA, without any prescriber ‘SLS’ endorsement on the prescription

On receipt of an NHS prescription, pharmacy staff must check whether an item can be prescribed on the NHS prior to dispensing. Firstly, it is important for dispensers to determine if a prescribed product is classed as an appliance (medical device) or a drug (medicinal or non-medicinal substance such as a food supplement or cosmetic item).

For drugs: A drug is only allowed if it is NOT listed in Part XVIIIA (Drugs, Medicines and Other Substances that may not be ordered under the NHS) of the Drug Tariff. Certain types of prescribers in primary care are limited by regulations to order, using NHS forms, only certain specified products for example dentists are limited to prescribing for their NHS patients only those drugs listed in the Dental Prescribers’ Formulary (DPF) in Part XVIIA of the Drug Tariff when using FP10D forms. Additionally, certain drugs or appliances on the Selected List Scheme (SLS) can only be prescribed in certain circumstances, for the specified patient groups listed in Part XVIIIB of the Drug Tariff.

For appliances: The presence of a CE mark, (normally found on the outer packaging, information leaflet, or on the device itself) indicates whether a product is an appliance. Only devices listed under the Appliances section in Part IX (Parts IXA, IXB and IXC) of the Drug Tariff are allowed on NHS prescriptions.

If a pharmacy contractor receives a prescription for an item that is not allowed on an NHS prescription, it should not be dispensed by the pharmacy. The prescription cancellation process should be followed, and the prescriber should be alerted so that an alternative product permitted on the NHS can be considered, or where appropriate, a private prescription can be obtained.



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