Home General News
Prescription Switching Compensation for Pharmacy Contractors
As a result of the introduction of the new prescription pricing technology in early 2007 by the Prescription Pricing Division, the Capacity Improvement Programme (CIP) there has been a substantial increase in ‘switching' of prescriptions.
‘Switching' of prescriptions occurs if the PPD does not agree with the charge group (paid or exempt) in which a prescription is submitted. For forms submitted as exempt: if a declaration of exemption by the patient (or their representative) is required, but is not provided, the PPD deducts a prescription charge from a contractor's payment for each item on that form. For forms submitted as chargeable: if the PPD detects a completed declaration of exemption, charges are not deducted for the items on that form.
Investigations by the PPD and the Pharmaceutical Services Negotiating Committee have revealed that the majority of the prescriptions ‘switched' did not have completed declarations of exemption on the prescription forms, where required. The PPD legacy pricing system was less successful at identifying these forms and therefore contractors had not been alerted to these problems prior to CIP implementation. In addition, instances of the PPD ‘switching' forms in error due to systems failure have been identified.
PPD, the Department of Health and PSNC have agreed compensation arrangements for any error due to PPD system failure and as a concession for contractors who may not have been aware of flaws in their own business processes for checking declarations of exemption on prescription forms, for the period to the end of December 2007.
Each contractor will receive a payment of 90% of the difference in the NHS charge values deducted due to the difference in average switching rates between legacy and CIP processes for each month that a pharmacy's prescriptions were processed through CIP until December 2007. This calculation will be specific to each pharmacy, based on the number of prescriptions switched by CIP in each month. The payment will reach contractors in early September 2008.
The compensation payments will exclude from the calculations months where PPD has already checked the switching and made adjustments to payments. The level of compensation recognises the delays in payment reaching contractors. PPD , the Department of Health and PSNC hope to reach agreement on arrangements for the early months of 2008 shortly.
It is essential that all contractors review their processes for ensuring that patient declarations are completed correctly. Further guidance is available on the PPD and PSNC web sites. There will be no concession made for patients' failure to complete the exemption declaration, where required, from 1st June 2008. PPD and PSNC will continue their work to audit the accuracy of the CIP system.
PSNC Comment
PSNC Chief Executive Sue Sharpe said: "The agreement follows long and complex negotiations with the Prescription Pricing Division.
"We still have a number of concerns about the CIP system that the PPD uses. The compensation we are announcing today covers 2007. We are still in discussion with the PPD and the Department of Health over further compensation for the problems that have persisted in the early months of 2008. It remains a key priority for PSNC to ensure that all errors are identified and addressed accordingly. It is essential that contractors review their processes for monitoring patient declarations from June onwards, as there will not be any concessions from then. PSNC will continue to work with PPD to audit the system on a regular basis."
More Information
Guidance on preventing prescription switching can be found in the CIP Section of this site. http://www.psnc.org.uk/pages/cip.html#Switched
Posted 8 July 2008