Advanced Services Funding

Advanced Services

MURs

The fee for delivering the Medicines Use Review and the Prescription Intervention Advanced Service is set out in Part VIC of the Drug Tariff. These fees are claimed via the FP34C Submission Form.

The fee an MUR is £28. Pharmacies that made arrangements to provide Advanced services before 1 October 2010 are able to conduct and be paid for a maximum of 400 reviews in the financial year 2010/11 (1st April 2010 - 31st March 2011). The limit for pharmacies that enter arrangements on or after 1 October 2010 is 200 for the financial year 2010/11.

The Department of Health has issued guidance to PCTs on the procedure to follow in the event that a pharmacy contractor claims payment for MURs in excess of the annual cap:

DH Guidance to PCTs on Contractors Exceeding the Annual MUR Limit

Claims made by pharmacy contractors for MURs are paid on trust. However, the NHS Counter Fraud and Security Management Service have confirmed that as with other systems where remuneration is paid based on a self declaration, the NHS has monitoring arrangements in place to detect fraudulent activity. To avoid any suggestion of a fraudulent claim, or simply poor practice in making claims for payment, PSNC recommends carrying out the following checks:

1. Before submitting any claim for payment of MURs (using Form FP34C), contractors should ensure that copies of the certificates of accreditation for every pharmacist who may undertake MURs at the pharmacy have been sent to the PCT (the PCT may monitor this during the monitoring visits);

2. Each month, carefully check the pharmacy records of MURs undertaken that month, to ensure that the pharmacist who undertook the MUR consultation is accredited (and the certificate sent to the PCT as above);

3. Each month count carefully the number of MUR reports for consultations carried out that month, to ensure that an accurate claim is made. These reports should be filed safely as they are the main evidence that an MUR has been carried out. Contractors may be required to produce them in the event of a Counter Fraud investigation;

4. Maintain a cumulative log of numbers claimed, so that the limit is not exceeded (currently 400 reviews per year);

5. If any MUR consultations are to be conducted away from the pharmacy premises, contractors should check that they have written confirmation of the consent of the PCT, which should be carefully filed in the pharmacy.

AURs

The fees for delivering the Appliance Use Review Service are set out in Part VIE of the Drug Tariff. These fees are claimed via the FP34C Submission Form.

The fee for an AUR is £28 for an AUR conducted on pharmacy premises or £54 for an AUR carried out in a patients home. If more than one AUR is conducted in the same location within a 24-hour period then £54 will be paid for the first AUR, and £28 for each subsequent AUR.

The maximum number of AURs for which claims for payment may be made is not more than 1/35 of the aggregate number of specified appliances dispensed during that financial year.

Stoma Customisation

The fees for providing the Stoma Customisation Service are set out in Part VIE of the Drug Tariff. When this service is provided, £4.32 is paid per qualifying* Part IXC item dispensed, regardless of whether customisation was required.

*Qualifying Part IXC items for stoma customisation are one-piece closed bags (under “colostomy bags” chapter heading of current Drug Tariff), drainable bags (under “ileostomy bags” chapter heading) and bags with tap (under “urostomy bags” chapter heading), items under “two piece ostomy system” and “flanges” chapter headings, as well as Skin Protectors and Stoma Caps.

To the National Contract Funding Section