The Pharmaceutical Journal
Vol 269 No 7214 p307
7 September 2002

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Pharmaceutical Services Negotiating Committee (www.psnc.org.uk)

Take care when signing up to become a repeat dispensing pilot, warns PSNC

The Pharmaceutical Services Negotiating Committee is warning pharmacy contractors in England not to sign up unconditionally to become repeat dispensing pilots.

In the September issue of its community pharmacy newsletter, the PSNC says that negotiations over the specification for the repeat dispensing service and the fees to be paid to contractors are still in progress. They are likely to continue beyond the 11 September deadline for applications from primary care trusts to be one of around 30 pathfinder (pilot) sites.

As a result, the PSNC is warning contractors and local pharmaceutical committees to "indicate an expression of interest to the PCT but not to sign the application form unconditionally. It should be signed 'subject to a satisfactory outcome to the PSNC/Department of Health negotiations'. If contractors sign unconditionally, they will effectively be signing up to an unspecified and unpriced service".

The PSNC says that its negotiations are based on the assumption that the service will be rolled out nationally, starting with a basic service and moving later to an enhanced service. Even at the basic level, increased professional responsibilities for pharmacists need to be recognised and properly remunerated, it says.

Under the Department's current plans, there will be a master prescription, of up to a year's duration, and an associated batch of prescriptions used for dispensing and reimbursement. Since the master prescription will be retained by the patient's chosen pharmacy then the patient will be obliged to use that pharmacy for the duration of the prescription. The PSNC says that pharmacists will need to:

• Undertake an initial screening, if necessary, to ensure that they are happy to take on increased responsibility for each patient

• Review periodically how patients are getting on with their medication

• Screen for side effects

• Identify other triggers that might require patients to see a general practitioner

• Record interventions, discussions and actions in the patient medication record

• Store batch issue forms, if requested to do so

• Alert patients before the master prescription expires

If GPs put all their chronic patients into the scheme, even at a basic level, then this could cause problems, particularly for patients who pay prescription charges and who are currently having their medication dispensed on a two- or three-monthly basis.

The PSNC says that the initial funding offer was totally inadequate and that initial prices negotiated have, on past experience, been difficult to increase.