The Drug Tariff sets out what National Health Service dispensing contractors will be paid for the products supplied as part of providing pharmaceutical services and the fees for providing those services in primary care.<\/p>
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<\/p>
The current arrangements in the Drug Tariff for paying for specials were introduced in 2011. The Drug Tariff sets the price that the NHS pays to dispensing contractors for dispensing some of the most popular specials. Setting a reimbursement price encourages dispensing contractors to obtain best value for the NHS while also ensuring patients received the medicines they need, when they need them. The products listed and their reimbursement prices are agreed with the Pharmaceutical Services Negotiating Committee and reviewed regularly. However, due to the number of specials that can potentially be prescribed, it is not possible to list a reimbursement price for all available specials.<\/p>
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Where the reimbursement price of a product has not been set, dispensing contractors are paid according to how the product is sourced. Where a dispensing contractor buys the product from a specials manufacturer or an importer, they must claim the invoice price of the pack size used to dispense the product minus any discounts or rebates received.<\/p>
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NHS England is responsible for commissioning pharmaceutical services in primary care and it is for NHS England to consider whether dispensing contractors have acted appropriately. In addition, the General Pharmaceutical Council is responsible for regulating the pharmacy professions should there be any concerns of professional misconduct.<\/p>
<\/p>
<\/p>
<\/p>
Many hospital pharmacies manufacture their own specials on the premises. Any procurement of unlicensed medicines via framework agreements for the use of NHS secondary care establishments in England is undertaken through tenders governed by the Public Contracts Regulations (2006), as amended, which require the procurement to be conducted in a transparent and equitable manner.<\/p>
<\/p>"} , "answeringMember" : {"_about" : "http://data.parliament.uk/members/2000", "label" : {"_value" : "Biography information for Earl Howe"} } , "answeringMemberPrinted" : {"_value" : "Earl Howe"} , "dateOfAnswer" : {"_value" : "2014-11-10", "_datatype" : "dateTime"} , "isMinisterialCorrection" : {"_value" : "false", "_datatype" : "boolean"} , "questionFirstAnswered" : [{"_value" : "2014-11-10T14:29:40.6106923Z", "_datatype" : "dateTime"} ]} , "answeringDeptId" : {"_value" : "17"} , "answeringDeptShortName" : {"_value" : "Health"} , "answeringDeptSortName" : {"_value" : "Health"} , "date" : {"_value" : "2014-10-27", "_datatype" : "dateTime"} , "hansardHeading" : {"_value" : "NHS: Drugs"} , "houseId" : {"_value" : "2"} , "legislature" : [{"_about" : "http://data.parliament.uk/terms/25277", "prefLabel" : {"_value" : "House of Lords"} } ], "questionText" : "To ask Her Majesty\u2019s Government what safeguards exist to ensure that the pricing of \"specials\" drugs prescribed within the National Health Service is consistent and non-discriminatory, including when prescribed by general practitioners.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"} , "tablingMember" : {"_about" : "http://data.parliament.uk/members/2037", "label" : {"_value" : "Biography information for Lord Lester of Herne Hill"} } , "tablingMemberPrinted" : [{"_value" : "Lord Lester of Herne Hill"} ], "uin" : "HL2433"} , {"_about" : "http://data.parliament.uk/resources/101009", "AnsweringBody" : [{"_value" : "Department of Health"} ], "answer" : {"_about" : "http://data.parliament.uk/resources/101009/answer", "answerText" : {"_value" : "
General Practitioner (GP) income is made up of global sum payments for carrying out essential and additional services under the contract. Practices may also receive further payments for specific services including:<\/p>
<\/p>
<\/p>
<\/p>
- enhanced services \u2013 those that require an enhanced level of service provision above what is required under the core contract. The additional payment for diagnosing dementia falls within this category; and<\/p>
<\/p>
<\/p>
<\/p>
- the quality and outcomes framework (QOF) - a voluntary incentive scheme that provides payment to GP practices for how well they care for patients based on performance against a number of agreed indicators.<\/p>
<\/p>
<\/p>
<\/p>
Specifically on diagnosis, a number of QOF indicators are concerned with the establishment of disease registers. In order to receive payment GPs are required to ensure diagnosis levels consistent with those expected for their population for the following conditions:<\/p>
<\/p>
<\/p>
<\/p>
- atrial fibrillation;<\/p>
<\/p>
- coronary heart disease;<\/p>
<\/p>
- heart failure;<\/p>
<\/p>
- hypertension;<\/p>
<\/p>
- peripheral arterial disease;<\/p>
<\/p>
- stroke and trans-ischaemic attack;<\/p>
<\/p>
- diabetes mellitus;<\/p>
<\/p>
- hypothyroidism;<\/p>
<\/p>
- asthma;<\/p>
<\/p>
- chronic obstructive pulmonary disease;<\/p>
<\/p>
- dementia;<\/p>
<\/p>
- depression;<\/p>
<\/p>
- schizophrenia, bipolar affective disorder and other psychoses and other patients on lithium therapy;<\/p>
<\/p>
- cancer;<\/p>
<\/p>
- chronic kidney disease;<\/p>
<\/p>
- epilepsy;<\/p>
<\/p>
- osteoporosis;<\/p>
<\/p>
- rheumatoid arthritis; and<\/p>
<\/p>
- obesity.<\/p>
<\/p>
<\/strong><\/p> <\/p> <\/p> <\/p> Each year NHS Employers, on behalf of NHS England, negotiates the new GP contract with the General Practitioners Council of the British Medical Association. This includes discussion of changes to the Enhanced Services and QOF.<\/p> <\/p>"}
, "answeringMember" : {"_about" : "http://data.parliament.uk/members/2000", "label" : {"_value" : "Biography information for Earl Howe"}
}
, "answeringMemberPrinted" : {"_value" : "Earl Howe"}
, "dateOfAnswer" : {"_value" : "2014-11-05", "_datatype" : "dateTime"}
, "isMinisterialCorrection" : {"_value" : "false", "_datatype" : "boolean"}
, "questionFirstAnswered" : [{"_value" : "2014-11-05T12:10:48.5057659Z", "_datatype" : "dateTime"}
]}
, "answeringDeptId" : {"_value" : "17"}
, "answeringDeptShortName" : {"_value" : "Health"}
, "answeringDeptSortName" : {"_value" : "Health"}
, "date" : {"_value" : "2014-10-27", "_datatype" : "dateTime"}
, "hansardHeading" : {"_value" : "General Practitioners: Pay"}
, "houseId" : {"_value" : "2"}
, "legislature" : [{"_about" : "http://data.parliament.uk/terms/25277", "prefLabel" : {"_value" : "House of Lords"}
}
], "questionText" : "To ask Her Majesty\u2019s Government, further to the announcement by NHS England that general practitioners are to be paid an additional £55 for diagnosing dementia in patients, what other complaints or illnesses diagnosed by general practitioners are already rewarded by payments additional to their salaries; and whether they will review the system of additional payments of this sort.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"}
, "tablingMember" : {"_about" : "http://data.parliament.uk/members/950", "label" : {"_value" : "Biography information for Lord Stoddart of Swindon"}
}
, "tablingMemberPrinted" : [{"_value" : "Lord Stoddart of Swindon"}
], "uin" : "HL2465"}
, {"_about" : "http://data.parliament.uk/resources/100854", "AnsweringBody" : [{"_value" : "Department of Health"}
], "answer" : {"_about" : "http://data.parliament.uk/resources/100854/answer", "answerText" : {"_value" : " The Department has not conducted any recent research on the effect of treatment of staff on standards of care and on the relationship between levels of pay and quality of social care services.<\/p> <\/p> <\/p> <\/p> As part of the development of Caring for our Future white paper in 2011, the Department undertook extensive engagement with both service users and carers who highlighted a range of issues they felt needed addressing to ensure high quality care and support is available. In addressing this, the Department, working with the Sector Skills Council \u2013 Skills for Care \u2013 and other partners, has implemented a range of policies that has included setting out clear minimum training standards, recruiting more apprentices and supporting the transformation of the social work profession.<\/p> <\/p> <\/p> <\/p> There are a number of factors that determine the quality of care provided in the social care sector, including the way staff are treated. Pay is not the single most significant factor in delivering high quality services.<\/p> <\/p> <\/p> <\/p> The Department is clear however that care providers must abide by the law with regards to payment of the national minimum wage and is taking steps to ensure this happens. The Department is liaising with the Department for Business, Innovation and Skills to name and shame any social care providers who do not comply with the national minimum wage legislation and Her Majesty\u2019s Revenue and Customs is continuing to carry out enforcement action in the social care sector and will investigate all complaints made by care workers that their employer is not paying them the national minimum wage. In addition, it is looking to ensure that the statutory guidance that will accompany the Care Act on commissioning and market shaping explicitly states local authorities should have evidence that contract terms, conditions and fee levels are appropriate to provide the agreed care packages with agreed quality of care.<\/p> <\/p> <\/p> <\/p>"}
, "answeringMember" : {"_about" : "http://data.parliament.uk/members/1439", "label" : {"_value" : "Biography information for Norman Lamb"}
}
, "answeringMemberConstituency" : {"_value" : "North Norfolk"}
, "answeringMemberPrinted" : {"_value" : "Norman Lamb"}
, "dateOfAnswer" : {"_value" : "2014-11-03", "_datatype" : "dateTime"}
, "isMinisterialCorrection" : {"_value" : "false", "_datatype" : "boolean"}
, "questionFirstAnswered" : [{"_value" : "2014-11-03T16:37:18.1346421Z", "_datatype" : "dateTime"}
]}
, "answeringDeptId" : {"_value" : "17"}
, "answeringDeptShortName" : {"_value" : "Health"}
, "answeringDeptSortName" : {"_value" : "Health"}
, "date" : {"_value" : "2014-10-24", "_datatype" : "dateTime"}
, "hansardHeading" : {"_value" : "Care Workers: Minimum Wage"}
, "houseId" : {"_value" : "1"}
, "legislature" : [{"_about" : "http://data.parliament.uk/terms/25259", "prefLabel" : {"_value" : "House of Commons"}
}
], "questionText" : "To ask the Secretary of State for Health, whether his Department has made an assessment of or received evidence on the effect on care standards of non-payment of the national minimum wage in the social care sector.", "registeredInterest" : {"_value" : "false", "_datatype" : "boolean"}
, "tablingMember" : {"_about" : "http://data.parliament.uk/members/4122", "label" : {"_value" : "Biography information for Alex Cunningham"}
}
, "tablingMemberConstituency" : {"_value" : "Stockton North"}
, "tablingMemberPrinted" : [{"_value" : "Alex Cunningham"}
], "uin" : "211866"}
, {"_about" : "http://data.parliament.uk/resources/100891", "AnsweringBody" : [{"_value" : "Department of Health"}
], "answer" : {"_about" : "http://data.parliament.uk/resources/100891/answer", "answerText" : {"_value" : " The National Institute for Health and Care Excellence (NICE) has published cancer service guidance which outlines how healthcare services for people with skin tumours, including melanoma, should be organised. In May 2010 NICE issued a partial update to the guidance, including new recommendations on the management of low-risk basal cell carcinomas in the community.<\/p> <\/p> <\/p> <\/p> NICE is currently developing a clinical guideline on the assessment and management of melanoma, which is currently planned for publication in July 2015.<\/p> <\/p> Further details of NICE\u2019s guidance on skin cancer are available at:<\/p> <\/p> <\/p> <\/p>