PM4B Law Update 3 Flashcards
Electronic Prescription Service
- for patients who have not nominated a pharmacy
- rx token is not tethered to a nominated pharmacy and they take a rx token generated at GP surgery to any pharmacy
- barcode on token is used to download rx from spine
New RX forms and EPD tokens
key changes
- new exemption box, U, who receive universal credit
- removal of X, prescribed free of charge contraceptives
- FS, free supply of sexual health treatment: new prescriber endorsement
- merging of ages A and C to just A
- Reword G to prescription exemption certificate issued by ministry of defence
What proof evidence do I need to request from a patient to confirm their entitlement to UC prescription charge exemption?
- patients should present their last UC award notice
- advise patient that NHS checks are routinely undertaken to verify that persons are exempt from payment of NHS prescription charges are part of preventing fraud
- evidence not seen should be ticked on paper prescription/EPS dispensing system
why has FS endorsement been introduced?
- enable prescribers to indicate to pharmacy staff that product is being prescribed for treatment of STI and can therefore be provided to patient FOC
- only prescribers can apply FS endorsement
- without FS endorsement, prescribed treatment would be treated as chargeable item
- of patient claims its to treat STI, but no endorsement, prescription need to be returned to prescriber for correct endorsement
How to endorse FS?
signing next to each item prescribed for treatment of STI
-select FS on system for each item
Electronic CD prescriptions
all 2 and 3 CD atomically processed electronically for patients who use EPS for their existing prescriptions
- pharmacies receive EPS should dispense like any other
- for signatures, can be captures on back of dispensing prescription token, with these tokens being sent to NHSBSA in same month the claim is submitted
Exceptions of automatically processed electronic CD Rxs
- oral liquid methadone: paper FP10 prescription will still need to be generated for drug to allow pharmacy to claim correct fees
- instalment prescribing: EPS cannot be used for FP10MDA prescribing
New GP contract- fax machines and EPS
if GP have NHS mail, can’t use fax machine
-even if patient has not nominated a pharmacy for purpose of EP, GP may issue them with EPS token, which includes barcode to allow pharmacy to retrieve required info from NHS spine
Signing Prescriptions
- exempt right now due to social distance measures
- must tick the relevant exemption or paid category on behalf of patient
- EPS, the patient charge or exemption deceleration is made via electronic message
Cannabis based products for med use
epidyolex: treatment of seizures in patients 2 or over alongside clobazam only if:
- frequency of drop seizures is checked every 6 months, and cannabidiol is stopped if frequency has not fallen by at least 30% compared with 6 months before starting treatment
- company provides cannabidiol according to commercial arrangement
(rx valid for 6 months, emergency supply can be given and prescriptions can be repeatable for epidyolex)
Sativex: oromucosal spray has CBD and THC, use for relief of spasticity associated with MS
- recommended offering a 4 week trial to patients with mod severe spasticity if other treatments have failed
- can be continued if patient receive 30% reduction in spasticity related symptoms
Current prescribing status of cannabis based products
- initial rx of CBPM must be made by a specialist medical practitioner
- prescriber should also have a special interest in condition being treated
- patient and carers must be involved in treatment decision
- efficacy and safety should be monitored and evaluated
Broad Requirements of CBPMs
1) contains cannabis, cannabis resin, cannabinol, cannabinol derivative
2) produced for med use in humans
3) regulated as a med product or an ingredient of a med product
Unlicensed CBD products
- considered food supplements
- falls outside med legislation as has no med claims made
- not contain T?HC
Mometasone 50mg nasal spray
- now a p med for treatment of seasonal hay fever in adults over 18
- for up to three months treatment
- two sprays into each nostril until symptoms are controlled, then one spray into each nostril daily
- very common side effect is nose bleed
- common: headache, URTI, nasal discomfort
Lidocaine containing teething gels
- changed from GSL to P to improve safety in children
- pack size of oral lidocaine produced authorised for teething restricted to a max of 10 g
- reposition of oral lidocaine as second line, after non-pharmacological treatments
- lidocaine containing products for adults will be clearly labelled with warning that they cannot be used in treatment for teething children
