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PSNC agrees transitional methadone payments for hardest hit pharmacies

Business PSNC has agreed to three transitional payments for contractors "most at risk" from the payment changes - eligible pharmacies will be contacted by mid-July

PSNC has agreed to three transitional payments for contractors who are at risk of losing out under the new methadone payment system, saying it was "concerned about the level of potential impact" for certain pharmacies.

Under the arrangements, contractors who would have missed out on establishment payments due to the methadone changes would still be able to claim the minimum establishment payment until March 2013.

And where methadone income accounts for 25 per cent or more of a pharmacy's total professional fees and schedule two and three CD fees, they could receive two extra payments (see details below).

NHS Prescription Services (NHS PS) will calculate which pharmacies are eligible and contact them directly by mid-July.

The new methadone tariff came in to force on July 1. Read the full details of the transitional payments at psnc.org.uk

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The news came as PSNC acknowledged contractors' concerns over the new methadone tariff, which will introduce a prescription fee, but only pay professional and CD fees when the patient collects the medicine.

"The financial implications were calculated at a national level, but it was impossible to assess the impact on individual contractors as this is dependent on the practice of individual prescribers," the negotiating body explained.

PSNC said it had agreed the transitional arrangements to help contractors "most at risk" from the new methadone pricing structure. It added that it had pushed the Department of Health to give six months' notice of the changes, but said this had not been possible.

But Martin Bennett of Wicker Pharmacy, Sheffield, questioned whether the transitional payments were enough to make up for the shortfall some businesses would experience. He estimated that his pharmacy would miss out on £50,000 a year under the new methadone payment arrangements, and questioned PSNC's assertion that the changes were "cost neutral".

"If it was cost neutral, you wouldn't need this transitional arrangement," he said. "It's almost impossible to tell whether reducing drug addiction treatment fees was part of PSNC's strategy, or whether this was accidental."

Mr Bennett added that his pharmacy may fail to qualify for some of the additional payments. "It's impossible to calculate whether you meet the 25 per cent criteria, but I think our methadone income only accounts for between 15-20 per cent of our total professional fees," he told C+D.

"It's affected us to the tune of £50,000, so you'd think surely we would get a transitional payment. NHS PS will tell us whether we've qualified, but there's no way we can check that, " he added.

"What I don't understand is why they picked 25 per cent – it just seems an arbitrary number that someone came up with. You could understand if they said [methadone] income would need to amount to a certain figure, but with a percentage, you lose out if you do a lot of prescriptions," Mr Bennett argued.

PSNC told C+D it had agreed on a percentage threshold for the payments rather than a fixed sum to ensure smaller businesses didn't lose out. And it reminded contractors that the 25 per cent threshold did not include practice payments. "The threshold has been set at 25 per cent of total schedule two and three CD fees and professional fees but, due to the omission of practice payments from this criteria, this broadly equates to 20 per cent of total professional income," said head of pricing Harpreet Chana.

The new methadone tariff came in to force on July 1. Read the full details of the transitional payments at psnc.org.uk.


The payments explained

If methadone dispensing accounts for 25 per cent or more of your pharmacy's total professional fees and schedule two and three CD fees, you may be eligible to receive one or both of the following extra payments.


Professional and CD fees

From July to September, you will be paid whichever of the following is highest in value:

  • 90 per cent of your monthly average schedule two CD fees and professional fees for dispensing methadone from January to March this year
  • the monthly payment under the new system

From October, the criteria will drop to 80 per cent of the monthly average and will continue to drop by 10 per cent each month. These payments will end in March 2013, when they will be 30 per cent of the monthly average.


Advance payment

If your advance payment for July's submitted prescriptions is 70 per cent of June's advance payment or lower, you will be eligible for a readjustment. This means pharmacies will be paid the same amount as they received in June for the month of July. However, this adjustment is only available for July's prescriptions to help reduce effects on cashflow.



How will the eligibility criteria for transitional payments affect your income?

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6 Comments

Rashid Mahmood, Superintendent

wow!

Martin Bennett, Community pharmacist

Just think - this is supposed to be a "cost neutral simplification" imagine what they could do if they tried to reduce fees and make it complicated!!

Sachin Badiani, Pharmacy owner/ Proprietor

I'm pretty good with my maths, but even I find this methadone "simplification" system very difficult to understand.

How's it going with the legal action??? You will have a lot of supporters (methadone dispensing and non-dispensing pharmacies alike).

Z Rafiq, Community pharmacist

PSNC are not fit for purpose, the only negotiating committee who are actually damaging the very people who they speak on behalf of. I bet those at the top of the PSNC will be the toast of the Dept of Health for doing a wonderful job and who knows they may even get knighted in the end ( may be the only way to get rid of this bunch).

The NHS PS cant pay contractors correctly at the moment so to trust them to work out who is eligible for this new transitional payment seems odd.

Obviously, I along with many other independent contractors who dispense to a large number of methadone patients have been well and truley shafted (only word I can think of to describe the impact it is going to have on my pharmacy).

I have little hope for pharmacy in general if the PSNC are to continue our negotiations.
Are the PSNC the dept of health in disguise? or are the dept of health the PSNC in disguise?

This is just the beginning, believe me more pain is to come from the PSNC and it will filter down to everyone who works in a pharmacy, eventually reducing wages and good people losing jobs because our guardians the PSNC are too scared to ask the dept of health for renuminarations for services we are providing rather then proposing real term cuts and passing them of as simplifications. ( I think they think we have our heads stuck in the ground)

Mr CAUSTIC, Community pharmacist

psnc are not negotiating . they give in besides methadone payments we are losing out big time on broken bulk as well. we have not only given up trying to get b/b on dressings we are now losing out on any items under £50. so if you get a script for 10 tabs of a drug costing 49£ per 100 and you will not use it again you are £43 out of pocket. we lose on ensure as we cant get a discount on it from aah. we LOSE all the time. if the psnc cant negotiate we need to get a change at the top. or we should renegotiate their salaries down along with our income going down.

Sachin Badiani, Pharmacy owner/ Proprietor

Talk of the devil, there is a new item we had today where the item is packed in 60 sachets, but only 10 was on prescription. The 60 sachets are £41 for the box, so with the broken bulk taken away, we will lose money!

I will clarify with PSNC or NPA on Monday (have put it with the page 6 from July 2012 Drug Tariff)....

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