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1 t e info@forte.uk.com f forte.uk.com April 2016 The announcement in February of the result of negotiations between the GPC and NHS Employers was recognition from government that it needs to act to start dealing with the crisis occurring in general practice. An investment of 220 million into the GP contract for was touted as recognising the financial pressures that general practices are under. However, will this be enough to start to mitigate the state of emergency in practices? I recently met with four GPs from different practices and everyone vociferously expressed their concern over the demands being placed upon general practice. The figures do show this pressure, the number of patient consultations completed for each patient per year in 2012 was 8.3, up from 3.9 in 1995¹. Each practice I spoke to was trying a different model to manage the demand for , lists ten priorities, the fifth being the aim to strengthen primary care services. It talks about increasing the number of GPs by 5,000 by 2020, as well as increasing the non-clinical staff (such as pharmacists) available to practices. However, nowhere does the document address the elephant in the room, and that is to increase capacity by employing more staff which requires significant sustainable investment. The total spend on general practice has fallen massively as a percentage of total NHS funding, from around 11% to less than 8%². While on the other hand the NHS s transformation agenda has driven more complex healthcare demand into general practice. So far the NHS s answer on funding has been to provide one off funding to primary care such as the prime ministers fund, or tapered support as used in the practice pharmacist pilot. What general practice needs is a coherent, long term plan of investment to abate this serious crisis looming. appointments, some using the doctor led telephone triage, while another was using the on the day duty team. In essence all the practices were trying to do the same thing; and that was to ration and use efficiently as possible their limited capacity. The recently published NHS England business plan ¹Clinical Practice Research Datalink NIHR 2014 ² RCGP 2015 Mark Stone, DDA Board Member & Practice pharmacist, Tamar Valley 1

2 The Department of Health has granted the following price concessions for April 2016: Bumetanide 1mg tablets Celiprolol 400mg tablets Cimetidine 400mg tablets Flecainide 50mg tablets Flecainide 100mg tablets Lamotrigine 5mg dispersible tablets sugar free Mefenamic acid 500mg tablets Pioglitazone 15 mg tablets Pioglitazone 30 mg tablets No additional endorsements are required for price concessions. Price concessions only last for the month in which they are granted. Price Concessions can change during the month so additional items are sometimes added. Aripiprazole 10mg orodispersible tablets sugar free A Basic price Ciclosporin 100mg capsules C Basic price Ciclosporin 10mg capsules C Basic price Ciclosporin 25mg capsules C Basic price 8.49 Ciclosporin 50mg capsules C Basic price Co-careldopa 25mg/100mg modified-release tab C Basic price Co-careldopa 50mg/200mg modified-release tab C Basic price Mesalazine 250mg suppositories C Basic price Mesalazine 500mg suppositories C Basic price Orphenadrine 50mg/5ml oral solution sugar free 150ml A Basic price Tramadol 50mg modified-release tablets C Basic price 4.30 ***Basic drug price based on April 16 Drug Tariff ***Purchase price based on Forte Direct pricing please call for details

3 I was trained many years ago within a Pharmacy and was surprised at the differences when I moved to work within a Dispensing practice. Same job you would think. The first and most obvious difference is that Pharmacies need a pharmacist and a GP dispensary does not, although you may employ one. Pharmacies can use the word Pharmacy and Pharmacist to describe their services and use the NHS Green Cross Pharmacy Logo. GP dispensaries cannot. A dispensing Doctor can only dispense to patients registered as a dispensing patient or a temporary resident. We can also dispense personally administered items to any patient. A pharmacy can dispense to any patient. The Drug Tariff When looking at the Drug Tariff you need to be aware that large parts do not apply to a Dispensing Doctors and only applies to Pharmacy Contractors and Appliance contractors. NCSO no cheaper stock obtainable listed in the Drug Tariff is only available to pharmacies and not Dispensing Doctors, but concession prices for drugs apply to both. These you will need to check each month. Part 11 Drugs for which a discount is not deducted (ZDs) applies only to pharmacies and not Dispensing Doctors. Part 111 A. Professional fees apply to Pharmacy Contractors but we can claim XP 20 for MHRA specials. Broken Bulk applies to both Pharmacies and Dispensing Doctors. Remote Delivery rule Part XV1 paragraph 3 ONLY applies to Dispensing Doctors and not to pharmacies. Part XIVA Fraudulent prescriptions. This only applies to Pharmacies MURs (Medication Use Reviews) are only done in Pharmacy. Dispensing Doctors if signed up the DSQS will do DRUMs (Dispensing Reviews of the Use of Medicines) The end of the Month prescription submissions is also very different. We don t have to use Red separators for items with broken bulk, out of pocket expensive or expensive drugs. VAT is not payable on private prescriptions dispensed by a Pharmacy but a Dispensing GP must add VAT. Dispensing Fees- These are different. Pharmacies fees are set out in the Dug Tariff and dispensing Doctors can be found in GMS Statement of Financial Entitlements. These are some but not all of the differences you will encounter when moving between a Pharmacy and Dispensing Doctor. Hazel Harris, Dispensary Manager Wye Surgery It is important that we hold the most up-to-date information regarding our customers. If you have recently changed any off your details, such as your name, address, telephone. Please let us know by ing info@fortegroup.uk.com or alternatively contact us on opt#3 3

4 The are pleased to invite you and your colleagues to join our FREE Open Surgery Workshop with Dr Richard West and Lesley Strong on the 17/05/16 at 7pm at the Park Farm Hotel, Norwich Rd, Hethersett, Norwich, Norfolk, NR9 3DL. Don t miss this exciting opportunity to experience an open surgery workshop with Dr Richard West and Lesley Strong. This session is aiming to support delegates with understanding their medical and dispensing business; identifying issues and problems and providing detailed ideas for solutions in order to enhance business performance. This is your opportunity to bring live practice examples and case studies, sharing good practice and ideas with local practices and gain valuable insight into the challenges your practice are facing in dispensary management. Date: 17th May Time: 7:00-9:00 Location: Park Farm Hotel, Norwich Rd, Hethersett, Norfolk, NR9 3DL. Meeting Chairs: Dr Richard West - Chairman of Dispensing Doctors Association Lesley Strong - Managing Director, Forte Pharma Ltd In Partnership with Discussion Points: Profitability, Cost, local and HR issues and maximising potential for your DISPENSING DOCTORS ASSOCIATION dispensing practice. Who Should attend: GPS, PM, Business Managers & Dispensary Managers and Lead Dispensers Please contact us to book your FREE place - info@fortegroup.uk.com. Phone : opt#3 The full training schedule of events is available on our website We look forward to seeing you there, The Following companies have supported the meeting by way purchasing exhibitor stand space; Alliance Healthcare, Forte Direct, Takeda 4

5 92% 60% 76% 95% 75% 75% Almirall (except Eklira) RWM Y Y Y Y Y Y Y Allergan Ltd Y Y Y Y Y Y Y AmCo RWM Y A Menarini Pharma Y Y Y Y Y Y Y Astellas Pharma Ltd Agency Y Y Y Astra Zeneca Agency Y Y Y Y Y Bayer RWM Y Y Y Y Y Y Y BGP RWM Y Y Y Y Y Y Y Boehringer Ingelheim RWM Y Y Y Y Y Y Y Chiesi RWM Y Y Y Y Y Y Y Daiichi Sankyo RWM Y Y Y Y Y Y Y Eli Lilly Agency Y Y Y Y Y GSK Agency Y Y Janssen Cilag Ltd RWM Y Y Y Y Y Y Y Leo Pharma RWM Y Y Y Lundbeck RWM Y Y Y MSD RWM Y Merck Serono RWM Y Y Y Y Y Y Y Napp RWM Y Y Y Y Y Y Y Novartis Pharmaceuticals RWM Y Y Novo Nordisk RWM Y Pfizer Agency Y Y Y ProStrakan Y Y Y Y Y Y Y Roche Diagnostics RWM Y Y Y Y Y Y Y Takeda Y Y Y Y Y Y 5

6 Discounts / Rebates Summary As part of our ongoing developments to increase visibility to show the rebate benefits you receive from being a Forte member all in one place. From March 2015 your Eligible Medical Discount (EMD) is now paid directly into your bank, along with any ZD, Generic, Surgical or Specials rebates. OffSta aemena 1) ReducedSWholes lersdiscounas - Direct reduction off payment due Breakdown is summarised and the breakdown shown on final page 2) MDtSVia credit note Breakdown by Manufacturer shown on statement, total shown as HZ prefixed credit note. 3) Asaell ss AZ prefixed credit note. 4) Qu raerlysenh ncedsreb aes HZ prefixed credit note. 6

7 BACtSP ymenas Paid first week of following month e.g. March rebate paid in May Statement sent to customer address 1)SSTermsSreb aess(emds/sturgic ls/szd) Forte Generics receive a further breakdown by product line via 2)SStpeci ls SAnother statement sent of which the payment includes rebate & handling charge. 7