Following the Department of Health and Social Care’s (DHSC) announcement of three new Serious Shortage Protocols (SSPs) for Hormone Replacement Therapy (HRT) medicines, PSNC has created a briefing titled ‘HRT Serious Shortage Protocols (SSPs) FAQs‘ to help pharmacists understand the requirements of these SSPs.
In addition, to support pharmacy teams, PSNC has also put together some helpful reminders and top tips on the correct SSP endorsement and submission requirements.
Always double check that endorsements reflect the requirements outlined in the supporting guidance published for each SSP on the dedicated page of the NHSBSA’s website.
When endorsing using EPS, contractors are reminded to select the SSP endorsement and input the correct three-digit reference number leaving a space in between ‘SSP’ and the three-digit reference number for example, SSP 019. Remember to insert the leading zero in the three digit reference number.
Each of the affected HRT medicines has its own SSP reference number. Check that the correct SSP number is endorsed for e.g. for Oestrogel® Pump-Pack 0.06% gel the SSP endorsement should be ‘SSP 019’. Please note the ‘NCSO’ endorsement is no longer accepted for SSPs.
Endorse the SSP product dispensed including the quantity. Ensure your endorsements are accurate and clear – NHSBSA processing staff must be able to determine what has been supplied. Contractors should note that SSP claims submitted using EPS tokens are no longer permitted.
No prescription charge is payable if a patient receives a smaller quantity of the medicine than the quantity originally ordered on the prescription if it was supplied in accordance with a SSP for a reduced quantity.
If a patient normally pays for their prescriptions, the paid status should be selected even though no charge is taken for the three months’ worth of HRT medicine supplied in accordance with the SSP. Once submitted for payment, the NHSBSA will recognise the SSP endorsement and process the prescription as a no-charge item i.e. no prescription charges will be deducted by the NHSBSA.
NHSBSA will continue to apply charge deductions for any other chargeable items dispensed on the same prescription form with mixed items (affected HRT medicine prescribed with other items).
If patient is exempt from prescription charges, the correct exemption reason should be selected.
If any claims for SSPs have been endorsed incorrectly and before a claim is submitted for payment, where PMR systems allow, contractors may be able to retrieve any submitted EPS dispense notification messages by using the claim amend functionality.
Please note that SSPs cannot be supplied past the period of SSP validity. Any other items on the prescription (such as an owing) can continue to be dispensed as usual but must be submitted for payment within three months of expiry of the SSP.
There is a separate declaration of monthly SSP claims on the digital FP34C submission form via the Manage Your Service (MYS) portal. Here, contractors should endorse the number of SSP claims made each month and not the number of items supplied in accordance with the SSPs. The number of items supplied in accordance with SSPs are to be declared along with the usual item totals
Please note that the NHSBSA will not be using the SSP declaration made on the FP34Cs for reimbursement purposes. Instead the SSP declaration is to provide the NHSBSA with an indication that SSP claim(s) are expected in that month. The SSP declaration is to support contractors when reconciling the number of SSP fees on their payment schedules against the number of SSP claims declared on the FP34C
Check whether your PMR system enables complete and correct SSP endorsements. If you have suggestions about how system usability and functionality could be improved, feed these back to your PMR supplier.
Invalid SSP claims
In recent months, the NHSBSA has received a significant number of invalid EPS SSP claims submitted by contractors. The main reasons for these incorrect/invalid SSP claims are due to:
Incorrect item endorsed – Incorrect item endorsed was almost always the same as original prescribed item rather than the alternative supplied in accordance with a valid SSP. Majority of the SSP errors were for incorrect item endorsed on the EPS messages (Electronic Reimbursement Endorsement Messages (EREMs)).
Invalid or incorrect SSP reference number endorsed – For example SSP 000 (blank or invalid reference number), SSP (missing reference number), SSP 028 (incorrect number), SSP 20 (two instead of three digits).
SSP claims for prescribed items without an active SSP – SSP endorsed against items for which an SSP did not exist.
Claims for supplies made in accordance with an expired SSP:
No active SSP in place at the time of supply – ie SSP claimed for items on prescriptions issued after SSP expired
Alternative item correctly supplied during the period of SSP validity but Dispense Notification message submitted after the period of SSP validity
Alternative item correctly supplied during the period of SSP validity and the Dispense Notification message submitted during the period of SSP validity but the EREM or Claim Notification message submitted after the 3-month claiming window.