A disallowed item is one that has NOT been passed for payment by the NHS Business Services Authority (NHSBSA). Please check your disallowed items history on Manage Your Service (MYS) portal to identify the list of unpaid items and reasons why the item was disallowed by the NHSBSA. If you believe an item has been incorrectly disallowed, you should submit a challenge to the NHSBSA, who will investigate the issue and rectify any missing payments if a processing error is identified.
It is important to note that disallowed items are only held on MYS for a period of 18 months from the date they are first sent to the pharmacy; if you have not reviewed and challenged any disallowed items before this deadline has passed, these items will be deleted from the system.
Community Pharmacy England has identified two examples of products that may have been incorrectly disallowed by the NHSBSA either due to operator error or because certain available products were not listed on NHS Dictionary of Medicines and Devices (dm+d).
1. Hypromellose 0.3% eye drops 10ml – If you had a generically written prescription for Hypromellose 0.3% eye drops (10ml) returned as disallowed by the NHSBSA because you endorsed a product that was not a listed Appliance in Part IXA of the Drug Tariff, the pharmacy can challenge NHSBSA’s decision if a drug was dispensed. We are aware that Hypromellose 0.3% eye drops is available as a licensed medicine from a manufacturer, Alissa Healthcare Research Ltd. However, until recently, NHSBSA was unaware of the availability of this manufacturer’s product, and consequently this item was missing from dm+d. Following representations made by Community Pharmacy England, NHSBSA has now added this product to dm+d to allow pharmacies to either select the drug or one of the branded appliances listed in Part IXA of the Drug Tariff. In a recent Hints and Tips article, NHSBSA highlighted that in April 2023, there were 74,058 occasions where Hypromellose 0.3% eye drops were prescribed via the Electronic Prescription Service. 25% of these were returned for more information. If pharmacies have had any generically written prescriptions for Hypromellose 0.3% eye drops referred back due to missing product information, these can be re-submitted by including endorsement of the product dispensed provided it was the licensed medicine by Alissa Healthcare Research Ltd or one of the branded appliances listed in table below.
Appliances listed in Part IXA – Hypromellose 0.3% eye drops 10ml
AacuLose Hypromellose 0.3% eye drops (TriOn Pharma Ltd)
AaproMel 0.3% eye drops (Essential-Healthcare Ltd)
Lumecare Hypromellose 0.3% eye drops (Medicom Healthcare Ltd)
Mandanol eye drops (M & A Pharmachem Ltd)
Ocufresh 0.3% eye drops (Blumont Healthcare Ltd)
Teardew 0.3% eye drops (Sai-Meds Ltd)
Xailin Hydrate 0.3% eye drops (Visufarma UK Ltd)
2. Emulsifying ointment 500 gram – If you had a generically written prescription for Emulsifying ointment 500 gram returned as disallowed by the NHSBSA because you endorsed a product that was not a listed Appliance in Part IXA of the Drug Tariff, the pharmacy can challenge NHSBSA’s decision if a drug was dispensed. We are aware that Emulsifying ointment 500 gram is available as a drug from a manufacturer, Alissa Healthcare Research Ltd. Similar to Hypromellose 0.3% eye drops above, NHSBSA was unaware of the availability of Emulsifying ointment as a drug from the same manufacturer, and consequently this item was missing from dm+d. Following representations made by Community Pharmacy England, NHSBSA has now added this product to dm+d to allow pharmacies to either select the drug or one of the branded appliances listed in Part IXA of the Drug Tariff. If any generically written prescriptions are received, these will be passed for payment based on endorsement of the drug (Alissa Healthcare) or one of branded appliances (see table below).
Appliances listed in Part IXA – Emulsifying ointment 500g
EmulsifEss ointment (Essential-Healthcare Ltd)
Ovelle emulsifying ointment (Ennogen Healthcare Ltd)
How to challenge disallowed items
To challenge disallowed items returned via Manage Your Service portal, pharmacy owners can click on a link available under the disallowed item displayed on the portal. A free-text box is provided for a contractor to provide a reason as to why they believe the item has been disallowed in error, and to provide a contact email address. Once a challenge is successfully submitted, the information is sent directly to the NHSBSA Helpdesk to action, removing the need for contractors to send a separate email or make a telephone call. If a disallowed item is successfully challenged, NHSBSA will reimburse the item and any payment adjustments will be reflected in the next Schedule of Payments. If a pharmacy contractor remains unsatisfied with outcome of a disallowed item challenge, they can email their query to email@example.com for further advice on the matter.
Common reasons for disallowed items
Items issued on NHS prescription forms are disallowed by the NHSBSA for many reasons. The top three reasons (including the corresponding disallowed code) for disallowed prescriptions are:
DA1 – As certain drugs and other substances as listed in the Drug Tariff Part XVIIIA (i.e. The limited list) cannot be allowed in these circumstances;
DA2 – As it is not an appliance or chemical reagent listed in the Drug Tariff (ref. Drug Tariff, Part 1, clause 2 or 3); and
DA3 – As it is not a drug, appliance or chemical reagent listed in the Drug Tariff Part XVIIB(i) from which a Nurse Prescriber may order on prescription form FP10P.
There may be instances where a prescription has been disallowed because NHSBSA records indicate that a nurse does not hold the appropriate qualifications to prescribe a product that is not listed in the Nurse Prescribers Formulary. If this nurse prescriber is also registered as an independent/supplementary prescriber, the disallowed prescription can be challenged via MYS.
For more information on referred back items please refer to our webpage on Prescription returns and Briefing 020/22: Understanding prescription returns and disallowed items.