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Part IX Changes from April 2010

Part IX Changes from April 2010. Ashley Kilgas General Manager North West Ostomy Supplies. Agenda. Background of Part IX What are the changes to Part IX? How does it affect Dispensing Doctors? The solution What to do next? Questions. Background of Part IX.

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Part IX Changes from April 2010

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  1. Part IX Changes from April 2010 Ashley Kilgas General Manager North West Ostomy Supplies

  2. Agenda • Background of Part IX • What are the changes to Part IX? • How does it affect Dispensing Doctors? • The solution • What to do next? • Questions

  3. Background of Part IX • Appliances Section in the Drug Tariff - 3 parts • Part IXA – Wound care and catheters • Part IXB – Incontinence • Part IXC – Stoma • Part IX appliances are dispensed in primary care by • Pharmacies – operate under schedule 1 of Pharmaceutical Terms of Service • Dispensing Doctors – operate under schedule 2 • Dispensing Appliance Contractors – operate under schedule 3 • Pharmacies, dispensing doctors and appliance contractors have different remuneration and reimbursement arrangements but there are many similarities

  4. Dispensing Appliance Contractors • 2 types of Dispensing Appliance Contractors • Manufacturer owned (Vertically Integrated) • Convatec – Amcare • Coloplast – Charter Healthcare • Dansac/Hollister - Fittleworths • Independent (INDACS) • Trent Direct • Countrywide Supplies • SureCalm • Both traditionally do direct to patient • NWOS are independent – however provide an Agency Scheme which enables Dispensing Doctors to offer a service to rival that of a direct to patient one.

  5. Consultation Process of Part IX • Consultation in 2003 – realised incredibly complicated subject - not concluded • Consultation reopened in 2005 – purpose of consultation was to harmonise as far as possible between what DACs and Pharmacy Contractors get paid and the services they provide • Consulted on further 7 times • Overview of arrangements published April 2009 proposed changes April 2010 • Changes HAVE happened! - 1st April 2010 • Dispensing Doctors left out of consultation – they are remunerated as they are today • Other contractors have 9 months to comply with changes to regulations – i.e. 31st December 2010!

  6. What are the Part IX Changes? • On cost being removed from DACs – replaced with a set of fees for ALL • Essential services – payable to both PCs and DACs • Advanced services – available to both – optional • Essential services • Emergency supply • Repeat dispensing • Record keeping • Home Delivery of Stoma and Incontinence Appliances • Provision of wipes and disposal bags • Access to expert clinical advice • Referral and signposting • Clinical governance requirements • Advanced services • Product customisation (stoma appliance flange cutting) • Appliance use reviews (AURs)

  7. What are the Part IX Changes? • Set of fees for Essential services cover • Normal dispensing fee – 90p all Part IXA, B and C • Additional dispensing fee to cover provision of home delivery – £3.40 all Part IXB and C, only part of A (mainly catheters) – fee of £9.30 for the ISC (intermittent self catheters) listed in Part IXA • Fees for Advanced services cover • Customisation fee - £4.32 majority of Part IXC items • AUR fee - £28 done at premises, £54 at patients home • 1 in 35 limit • Can only be carried out by a Pharmacist or a Nurse that is employed by a DAC • The contractor has to be fully compliant with the Essential services before the advanced can be provided

  8. Table of Fees per Item – for Pharmacy (Essential Services)

  9. What does this mean? • Essential services - NOT OPTIONAL • Home Delivery of Stoma and Incontinence Appliances • Provision of wipes and disposal bags • Access to expert clinical advice • Advanced services - OPTIONAL • Product customisation (stoma appliance flange cutting) • Appliance use reviews (AURs) • Key points for Pharmacies are • They HAVE to make changes to their business to fall in line with Essential services • Have until 31/12/10 to comply with regulations • PCs will get more remuneration than now, but need to do more to get it

  10. What does this mean to DD’s? • Despite ours attempts to ensure Dispensing Doctors were in scope during the consultation – we were repeatedly told that they were outside the scope of these consultations! • Therefore DDs will be paid the fees as now • Good news • DDs don’t have to follow new regulations • Therefore those that are using an agency scheme can continue (with some minor modifications) • This will ensure that DDs can get access to all the fees available through such an arrangement

  11. Table of Fees per Item – for Using a Scheme

  12. NWOS Appliance Partnership • In acknowledgement of the regulation changes NWOS have re-branded the old agency scheme which has evolved to become ‘NWOS Appliance Partnership’ • This ensures greater transparency to satisfy the DH regulations that DACs now have to comply with • Benefits to you • Fast delivery service – next day • Free bags and wipes (on applicable products) • Stoma customisation • Access to expert clinical advice • Increased profitability • No cash outlay – NWOS dispense the item • Split packs so orders match script quantities • Quick payment – in advance of PPD

  13. What to do next? • For more info NWOS have tried to simplify the new regulations on our website www.nwossurgical.co.uk • We have stand at the conference – please feel free to come and enquire re changes and new offer • NWOS Appliance Partnership - gives you an opportunity to rival that of a direct to patient DAC whilst maintaining patient contact within your practice and improving your profit.

  14. Thank you for listening Questions?

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