Streamlining Practice Processes to Maximise Income for Personally Administered Items

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1 Streamlining Practice Processes to Maximise Income for Personally Administered Items Tracy Hole Ash Lane Consulting Licensed by The Surgery Network 6 th September 2016

2 Business Platforms Expert support team The Benefits: Training Consulting PPA Reviews

3 Streamlining Practice Processes to Maximise Income for Personally Administered Items Your payments the basics Why profits are under pressure How to increase your income and profits Myths

4 The Basics: Payments from Prescription Services (PPA) Profit = Drug Payment Income Supplier Costs Suppliers Income = NHS Refund Price - Discount + VAT + Dispensing Fee Set the Price paid

5 External issues reducing profits Dispensing Fees are decreasing Suppliers Some prices have increased to, or exceeded Refund Price Pharmacies are targeting flu patients

6 Flu s and the impact on your PAI income and Profit Flus make up: 30-50% of your PAI income, 60-80% of your PAI profits ( 6/patient vaccinated) Plus you get an enhanced service fee of 9.80/patient Total profit per patient, (exc staff overtime) 16/patient 10.4 million given in 2015/16 Your profits are at risk Private community pharmacies are being licensed to give flus to patients 2015/16 they gave 250,000 Expect an increase in 2016/17

7 Issues in surgeries reducing profits FP34 Surgery make purchases Personally Administered Items Prescriptions raised Claim submitted Income received Assume best price paid Assume knowledge of claimable items Assume Px always raised Assume all items claimed Assume income = claim Reimbursement process not in control : Everyone is involved Lack of information No end-to-end view

8 What can be done?

9 Where to start GMS STATEMENT OF FINANCIAL ENTITLEMENTS Personally administered drugs and appliances, and those used for diagnosis 17.4 A contractor who is providing services under a GMS contract may, whether or not the contractor is authorised or required to provide dispensing services to specific patients, be entitled to the payments listed in paragraph This applies only in relation to the following products (a) (b) (c) (d) (e) vaccines, anaesthetics and injections; the following diagnostic reagents: Dick Test; Schick Test; Protein Sensitisation Test Solutions; and Tuberculin Tests (i.e. Koch Test, Mantoux Test, Patch Test and Diagnostic Jelly); intrauterine contraceptive devices (including drug-releasing IUCDs, contraceptive caps and diaphragms); pessaries which are appliances; and sutures (including skin closure strips). To check individual items go to: 9

10 Track PAIs from through the surgery FP34 Surgery make purchases Personally Administered Items Prescriptions raised Claim submitted Income received Track PAI orders Track what s being used Track what s been submitted Calculate expected income and profit Checks & Balances introduced Communicate and share information across the team

11 Visual cues to remind everyone what to claim For all reimbursable items: Label the shelves with the item name and a dot Put up posters Ensure everyone knows what the spot means

12 Myths it s not worth claiming low-cost items It s all about the dispensing fees NHS Refund Price/ item Income /item inc Disp Fee Income /pack inc Disp Fee Item Minims tetracaine 20pk Revaxis each Sutures W320 12pk Steri-strips 6x75 only 12pk Emla cream 5g tube each Instillagel 11ml 10pk

13 Myth: It s never worth risking money on highcost items It s all about the supplier discount Healthy discount means big profits: Income Cost Profit /patient /year Zoladex 10.8mg 1, Zoladex 3.6mg Prostap11.25mg 1, Prostap 3.75mg 1, Decapeptyl 22.5mg Decapeptyl 11.25mg Decapeptyl 3.75mg No discount means potential loss, but you have to check: Income Cost Profit /injection Denosumab 120mg Xgeva ( 10) Denosumab 60mg Prolia

14 In conclusion Profits are under threat You can take steps to counter: Protect and maximise your flu income Know what is claimable Track PAIs from the point of order through the surgery Visual cues (orange dots) Claim all low-cost items Claim high-cost items when there is a profit We can help contact us to find out more

15 Thank you Any questions? Tracy Hole New Street, Salisbury, SP1 2PH

16 Introduction to The Surgery Network The Surgery Network is dedicated to helping GP surgeries improve their business performance. Using our unique business platform and expert team, we deliver solutions that achieve cost savings, increased revenue and efficiency improvements. We achieve this by providing: Unique supply management solutions that ensure members achieve the best prices and service levels. (We are independent of suppliers). Purchasing, inventory and financial management tools that includes detailed analytics on purchasing performance; stock valuation; cost optimisation Support for multi-site practices that provide central control and enable efficiency gains to be applied from one site to another Improved organisational procedures that streamline operations to reduce stress levels and achieve time savings. These are backed up by an expert team who are always available to help. Increased practice revenue. Our platform is designed to work with Prescriptions Service reimbursement processes, ensuring maximise your claims for the income you are entitled to. The benefits Our business platform delivers immediate benefits in terms of reduced costs (typically 20% to 40% less), increased revenue, reduced workload, more management control and a less stressful working environment. A service that pays for itself We charge a fixed monthly fee, dependent on Practice size. Our costs are easily covered by the savings made on purchase items alone. Contact us To find out more, please get in touch: Call: Web: surgerynetwork.org info@surgerynetwork.org Request a Free Practice Review We will conduct a financial review that compares your current purchasing costs with the prices possible using our platform. There is no cost and no commitment for this. The detailed report provides you with a benchmark of your current procurement performance and quantifies the savings you would make by joining The Surgery Network.