Business Services Organisation Pharmacy Roadshow

1. Business Services Organisation Pharmacy Roadshow

2. Revised Part 1 Drug Tariff Wound Management Formulary General Coding Issues Electronic Account Information

3. Revised Part 1 Northern Ireland has adopted England Part 8 from 1st April 2011 Increased the number of Part 1 items to approximately 2,300 Approximately 1,600 new Part 1 codes Approximately 370 non-Part 1 generic codes deleted Approximately 50 old Part 1 codes deleted

4. Revised Part 1 Category M Prices apply in Northern Ireland Category R No longer appear in NI Drug Tariff Three new drug categories A, C and E

5. Category “A” Category A is for Generic medicines which are widely available from wholesalers Examples Clotrimazole 1% cream 50g Isoniazid 100mg tablets Kaolin and Morphine mixture

6. Category “C” Category C items are based on the list price for a particular brand or manufacturer’s product. The Drug Tariff is annotated with an indication of which product forms the basis for reimbursement price. Examples Atorvastatin 20mg tablets – Lipitor Miconazole 2% cream – Daktarin Sotalol 40mg tablets – Beta-Cardone

7. Category “E” Category E products are those that can be extemporaneously dispensed with the reimbursement price based on the costs of the ingredients required to dispense the product. Examples Ammonium chloride mixture sugar free Hydrogen peroxide 1.5% ear drops Sodium chloride 0.9% solution

8. Current Position with Respect to Implementation Ministerial approval received on 24th March A complete new Codebook sent out to all contractors Separate Part 1 section sent to all contractors Meetings ongoing with pharmacy system suppliers

9. Use of Old Codes Encourage all contractors to use new codes If old codes are used BSO systems in place to ensure correct payment

10. Processing of Part 1 items Part 1 items have been subject to auto-coding process since April 2010 prescriptions There has been no change to the application of auto-coding to Part 1 items We are still using the smallest pack first. DM&D rules guide shown on BSO website >90% of large barcodes are now able to be read

13. Batch “A” – Fully Coded Hand written fully coded Fully coded no amendment to preparation type or quantity prescribed

15. Batch “B” – Part Coded/ Uncoded Normal Part Coded / Uncoded Amended Part 1 item forms Quantity prescribed/ dispensed amended Preparation type amended Item not dispensed Item added

17. Batch “F” – Multiple Dispensing Complete batch Fully coded no amendment Amended batch Quantity prescribed/ dispensed amended Preparation type amended Item not dispensed Item added

19. Batch “K” – Repeat Dispensing Complete batch Fully coded no amendment Amended batch Quantity prescribed/ dispensed amended Preparation type amended Item not dispensed Item added Intervention code used

20. All Other Batches To be submitted as before No change

21. Frequent Questions Do I need to move fully hand written forms? No Do I still need to code my prescriptions? Yes Do I need to move a form with a non-dispensed item Only if item is Part1

22. Frequent Questions Do I need to separate out prescription forms which have the quantity specified as days supply by the GP system? No. What should I do if a doctor amends the directions after printing a prescription form containing Part 1 drugs? No action required.

23. Frequent Questions Do I need to separate out prescription forms with quantities specified as number of packs ie 2 x op or 3 x 28? No. If you have any concerns regarding a quantity move the prescription form to part coded or amended batch as appropriate.

24. Frequent Questions Is there a central point for questions? E-mail your questions to dmd@hscni.net

25. Wound Management Formulary New Wound Management Formulary - Part 3g Effective from 1st May 2011 Deleted dressing no longer allowed New section on BSO website – “Guide to Wound Management”

26. Appliances and Wound Management Formulary Caution No code – think is this allowed Generic description Only appliances and dressings listed on the CURRENT Drug Tariff are allowed Do not refer to BNF for prescribing information about dressings or appliances

27. Hosiery Items Not Allowed Tights Flight socks Anti embolism stockings

28. Hosiery Coding Measured and Fitted M&F code should only be used once per patient Further scripts should be coded with standard code

29. Lymphoedema Garments Listed separately in Drug Tariff Only types on Drug Tariff allowed Actilymph, Jobst, Mediven etc.

30. Endorsements ENDORSEMENTS NORMALLY ONLY NEEDED WHEN AN ITEM IS NOT CODED

31. Endorsements ZD Item has to be on ZD List in NI Drug Tariff Only endorse ZD when item is not coded Endorse ZD on main body of script, not in code column ZD will not be given unless claimed DO NOT ENDORSE ZD AGAINST ALL UNCODED ITEMS

32. Endorsements CD Only endorse CD when not coded Endorse CD on main body of script, not in code column

33. Endorsements Out of Pocket Claims Must endorse claim on main body of prescription Ingredient cost (if applicable) Administration cost Postage claim Must submit a valid invoice Prescription serial number Ensure pack size is stated on invoice

34. Using Current Codes Make sure your Code Book and Labelling System are up to date Don’t code from Patient Records

37. Coding and Quantities Items Coded Over Packs Otomize Ear Spray 5ml 6505/1 Difflam Throat Spray 30ml 3034/1 Calogen Supplement 500ml 2466/1 Gauze Swabs 100 1181/1 All Gluten Free Products, Nutritional Products, Foods etc Check Code Book

38. Shortages Phone BSO on 02890 90535654 to confirm Shortage Approval may be given to dispense an alternative and endorsement advised Continue to monitor shortage as status may change

39. Items Not Available At Tariff Price Proposal to implement NCSO status in NI with PCC English arrangements Monthly list published in Tariff Price obtained endorsed with NCSO

40. Not all Suspensions or Dilutions will be paid as Specials Check with BSO If you dispense a special against an item you could have made up You Will Lose Money Specials

41. Dispensing a Special Wide variation in costs of products available: Omeprazole suspension £24.21 - £555.53 Quetiapine suspension £113.90 - £1,599 Source from suppliers that provide quality products but at best value

42. General Bundle Issues Bundles should be submitted by 7th of month Late bundles cause the BSO major problems Potentially delay your payment Use current HS30 forms and don’t swap Submit bundles in secure and compact packaging HS30’s and address labels ordered on 02890535652

43. General Bundle Issues Don’t use sellotape Don’t use staples or ensure they are removed Avoid sticky labels and don’t cover barcodes One contractor took a complete day to scan 10 staff prepping bundles every day

44. Sandy Fitzpatrick Head of Information and Registration Business Services Organisation

45. Content Overview of existing reports Review of new electronic reports Advantages of new report

49. New format report

50. Advantages of new report Searchable for particular drugs Searchable for particular prescriptions Improved transparency of payments No requirement for cost level report > £100 No requirement for copies of scripts > £500 Reduced storage/easier filing Old style reports will be available initially for those not wanting to/capable of getting e-reports

51. If you want to get these new electronic reports then email us at:dmd@hscni.net orpharmacyaccount.query@hscni.net