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Missing signature accounts for most script switches

Webinar highlights ways to reduce wrong group movement

August 10th 2020

Tagged: DDA news Dispensary guidance news England

By Charles Gladwin

Missing signatures account for around 95 per cent of prescription switches when being processed for payment. Another common reason for switching is where no marks or signature have been made on a form submitted as exempt.

With dispensing practices submitting paper FP10s for around 6 million items each month, practices could be losing hundreds of pounds a month if they do not ensure declarations and endorsements are properly completed. The NHSBSA is therefore encouraging dispensaries to collect a signature on all exempt scripts as good practice, even for contraceptives.

End-of-month script submission and script switching were the themes of the latest DDA webinar.

Mark Gibbons, pharmaceutical technical analyst at the NHSBSA, discussed the methodology of prescription processing and highlighted ways to reduce the number of forms that are switched.

The system scans both sides of paper prescriptions (old and new format FP10s) using Intelligent Character Recognition (ICR) software to look for marks in boxes and parameters elsewhere on the form. Around 70 per cent of scripts can be processed successfully this way. However, if the machine cannot analyse the script 100% successfully it will reject it for human inspection; it will never switch a script.

Staff scour these prescriptions for information to put the prescription into the right category. This means, for example, a signature outside of the signature box, or other marks or details indicating that the declaration was appropriate, could be accepted as exempt.

Where a box has been ticked but there is no signature, the script would be switched to non-exempt, except for contraceptives and personally administered (PA) items, or where the patient age implies fee exemption.

Other points raised in the webinar included:

  • dispensary staff may act as agents for patients and complete the declaration on a patient’s behalf, but the patient will be held accountable for a fraudulent declaration
  • in such cases and if appropriate, writing ‘COVID’ or ‘EXEMPT’ in the signature box may be sufficient for ICR processing
  • many (exempt) PA forms are submitted blank – writing PA in the signature box means the script should not be flagged up for human inspection, speeding up processing
  • submit contraceptive and PA scripts in their appropriate bundle without separating them out.

A survey during the webinar showed the impact of script switching:

How much has your practice lost as a result of switching between March and May 2020?

(based on 46 responses)

<£100 44%
£100-£500 24%
£500-£1,000 11%
£1,000-£3,000 15%
£3000-£6,000 4%
>£6,000 2%

The webinar also looked at the FS endorsement and use of the red separator. More than a quarter of practices indicated they are not yet familiar with the procedure. Only FS items should be separated out into the red separator, advised Mr Gibbons.

Are you aware of the red separator and the procedures for using it?

(based on 130 responses)

Yes 71%
No 29%

Matthew Isom, DDA Chief Executive, and Mark Stone, Practice Pharmacist at Tamar Valley Medical Practice and DDA Board member presented the hour-long webinar. It was co-hosted by Closer Still Media, organisers of the Best Practice Show, and sponsored by Teva.

The recording of the webinar is available online.

Previous webinars have looked at the NHS medicines delivery service and pharmaceutical needs assessments (PNAs) and the emergency COVID-19 regulations.