Rechecks for specials prescriptions with additional or supplementary product information

Rechecks for specials prescriptions with additional or supplementary product information

February 11, 2021

PSNC is aware that some pharmacy contractors have been left out of pocket because prescribers have free-typed the words ‘Special’ or similar, into the dosage area or notes section of a prescription, and the pharmacy has not been reimbursed for supplying a special in accordance with the prescriber’s instructions.

In this situation, pharmacy contractors can request pricing rechecks for any specials prescriptions where additional/supplementary product information included by the prescriber was not taken into account by the NHS Business Services Authority (NHSBSA) during prescription pricing.

Any additional/supplementary product information added by a prescriber to a different part of an electronic prescription (for example the dosage area or notes section), is not captured by the NHSBSA during pricing. Paper FP10 prescriptions with additional/supplementary product information are required to be submitted in red separators so that extra checks can be carried out by operators at the NHSBSA. However, there is no such facility for separating/flagging EPS prescriptions with additional/supplementary product information to the NHSBSA.

If a pharmacy has not been paid for supplying a product in accordance with any additional/supplementary product information added by a prescriber, a prescription recheck request can be submitted to the NHSBSA who will investigate and make any payment adjustments to the contractor if a pricing error is identified.

This type of recheck enquiry is not intended to be a substitute for best prescribing practice. However, it has been introduced as a safety net for scenarios where pharmacy teams find themselves with no alternative but to dispense a prescription in accordance with any additional or supplementary product information specified by the prescriber.

Why are certain prescriptions issued by prescribers where the request for special to be supplied is included as part of the dosage instructions?
When prescribing specials using EPS, prescribers should select the correct product description (or Actual Medicinal Product) displayed on prescribing systems. However, certain unlicensed medicinal products (specials) may not be selectable using EPS if:

  • the item is not listed on the NHS dictionary of medicines and devices (dm+d), or added in a timely manner
  • prescribing system suppliers have not ‘mapped’ across the appropriate products from the dm+d*
    *GP system suppliers perform ‘mapping’ to the dm+d at different intervals and do not always map their systems to every product listed on the dm+d. Therefore, some GP systems may not always display all the available product options with less commonly prescribed items and items newly added to the dm+d particularly impacted as these will not be ‘selectable’ for prescribers using EPS. EPS users should ensure their systems are kept up to date otherwise systems may not incorporate the latest data available. PSNC recommends that EPS suppliers synchronise to dm+d and Drug Tariff changes frequently (note that the dm+d is updated weekly by the NHSBSA with product and price changes)

A prescriber may not be aware of these issues when ordering a special using EPS and may use a workaround by free-typing instructions for the pharmacy to supply a special for example, into the dosage area of the prescription.

Advice for pharmacy teams

If an electronic prescription annotated with additional/supplementary product information is received by a pharmacy, it is strongly recommended to have such prescriptions appropriately rewritten/re-issued by the prescriber before dispensing, For specials, the prescriber will need to select the correct product description (AMP) if available on prescribing systems or, consider providing a replacement paper FP10 prescription form written as ‘Drug name (Special Order)’ to ensure that it can be accurately priced by the NHSBSA. For further information see PSNC’s factsheet on dealing with product information within dose area.

If, for any reason, obtaining a replacement prescription is not practicable and a pharmacy chooses to dispense a prescription in accordance with supplementary product information requesting a ‘Special’, a prescription recheck request can be submitted to the NHSBSA if a special was supplied and endorsed but not reimbursed, accordingly.

Recheck requests should be accompanied with suitable evidence for example, a screenshot image or copy of the EPS token showing the prescriber’s indication (supplementary product information) in the dosage area/notes section of the prescription. System suppliers have developed their systems to allow contractors to view and reprint tokens of EPS prescriptions previously submitted for payment.

As per the usual recheck process, all requests must be submitted no later than 18 months from the end of the dispensing month (for example, for prescriptions dispensed in January 2020, the request must be submitted before end of June 2022). Full details of the process can be found on PSNC’s prescription rechecks page.



Posted in: , ,


More Latest News >

Briefing MPs on COVID-19 costs

PSNC is continuing its work to brief Parliamentarians on the financial pressures facing community pharmacies. Ahead of the Budget, PSNC...

No Smoking Day 2021

No Smoking Day is a national campaign that encourages the nation’s smokers to make a quit attempt on the second...

PEPS payments information

Contractors signed up to the Pharmacy Earlier Payments Scheme (PEPS) will have received their payments on 1 March directly from...