Home Container Allowance, etc
Containers
In 2007, the NPSA published a patient safety alert on ‘promoting safer measurement and administration of liquid medicines via oral and other enteral routes which recommended that because more complex medication regimens are now being administered at home, primary care dispensers should be in a position to issue a range of oral syringes and as a minimum a 1ml, 5ml or 10ml syringe should be supplied depending on the dose prescribed. Part IV of the Drug Tariff outlines the arrangements for supplying containers, measuring spoons and oral syringes to NHS patients.
It is a contractual requirement for pharmacies to supply either a 5ml plastic measuring spoon or a 1ml,5ml or 10ml oral syringe with every oral liquid medicine, (except where the manufacturer's pack includes one).
Plastic oral syringes must be clearly labeled ‘oral' and/or ‘enteral' in a large font size, comply with appropriate British or European Standards and be wrapped together with a bottle adaptor and instructions. Choice of whether a spoon or syringe (and its size) is supplied will depend on the nature of the medication regime.
Pharmacy contractors are paid the container allowance, currently 3.24p per item for all items dispensed, regardless of whether or not the product was packaged in a container supplied by the pharmacy or dispensed with a spoon or oral syringe.
The level of the container allowance was originally set based on a study, the container cost inquiry, which reviewed the average costs to pharmacies of supplying containers to patients. The regulatory burden component of 2008/2009 annual funding uplift included consideration of the additional costs of the 1ml or 10ml syringes.
Additional Items
Where a prescription for eye, ear or nose drops or contraceptive jelly requires an applicator, contractors can endorse and will be reimbursed based on the Drug Tariff Part IXA price for a dropper bottle or Type 1 (Ortho) or 2 (Durex) vaginal applicator. Contractors should endorse the prescription AI along with full details of the additional item dispensed.
The Additional Item endorsement can also be used to claim payment for diluents dispensed with dry powder injections (where not specifically requested by the prescriber on the prescription), for example supplying water for injection along with a dry powder injection. Contractors should ensure that the diluent supplied is clearly endorsed on the prescription along with the initials AI and the pack size and manufacturer as required.
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