Subject: PharmaPlus Contractor Update – November Operational Briefing

Dear Member,

This update focuses on practical, contractor level issues drawn from recent national communications.

1. Community Pharmacy Workforce Survey – final reminder

• Contractual requirement for all pharmacy owners to complete the 2025 Community Pharmacy Workforce Survey.
• Deadline: by 11.59 pm on Friday 21 November 2025.
• Where groups or multiples complete centrally, local pharmacies must confirm whether head office is submitting on their behalf.

Failure to complete risks contractual non compliance. Treat this as a hard deadline.

2. November 2025 price concessions – first update

DHSC has issued the first set of November price concessions:

• Co careldopa 12.5 mg/50 mg tablets 90 – £5.97
• Co careldopa 25 mg/100 mg tablets 100 – £8.26
• Febuxostat 80 mg tablets 28 – £4.09
• Fexofenadine 180 mg tablets 30 – £3.89
• Ibandronic acid 150 mg tablets 1 – £18.40
• Latanoprost 50 micrograms/ml eye drops 2.5 ml – £1.83
• Mefenamic acid 500 mg tablets 28 – £28.01
• Methenamine hippurate 1 g tablets 60 – £17.80
• Olanzapine 2.5 mg tablets 28 – £1.84
• Olanzapine 5 mg tablets 28 – £1.58
• Tolterodine 1 mg tablets 56 – £1.55
• Tolterodine 2 mg tablets 56 – £2.49
• Trihexyphenidyl 5 mg tablets 84 – £124.00

Key points:

• No rollovers from the previous month in this update.
• Concessions apply only for the month granted. Late month concessions can roll into the following month.
• No additional endorsements are required when a concession is in place.

Contractors should:

• Monitor CPE concession updates through the month.
• Continue reporting products that cannot be obtained at or below Drug Tariff price, with full supplier and purchase price details, so further concessions can be evidenced.

3. Ibandronic acid 150 mg tablets – supply issue

• Ibandronic acid 150 mg tablets are in limited supply until March 2026.
• This is the only licensed once monthly bisphosphonate.
• Alendronic acid 70 mg tablets and risedronate sodium 35 mg tablets (once weekly presentations) remain available and can support increased demand.
• DHSC and NHS England have placed the full details in the online Medicines Supply Tool and circulated a Medicine Supply Notification to pharmacy NHS email addresses.

Pharmacies should:

• Ensure dispensary teams are aware of the supply position.
• Use the Medicines Supply Tool routinely for current information.
• Liaise with prescribers for suitable weekly alternatives where appropriate.
• Use local shortage reporting routes where new supply problems are identified.

4. Referred back (unpaid) items – CPE video and resources (https://cpe.org.uk/our-news/funding-reimbursement-shorts-referred-back-items/)

Community Pharmacy England has produced a Funding and Reimbursement Shorts video focused on referred back items.

The content covers:

• Definition of referred back items and common reasons for non payment.
• Financial impact of unpaid items on individual pharmacies and the wider sector.
• A worked example of how to resubmit a referred back item correctly.
• Correct endorsement practice for different prescription types.
• Practical methods to reduce the risk of referred backs and to monitor them.

The video is supported by factsheets and briefings, including a “Top tips to maximise dispensing income” checklist.

This material is suitable for use in internal training sessions for pharmacists, ACTs and dispensers, with direct impact on cashflow and bad debt risk.

5. Export and hoarding restricted medicines – updated list (https://www.gov.uk/government/publications/medicines-that-cannot-be-parallel-exported-from-the-uk) 

DHSC and MHRA have updated the list of medicines that:

• Must not be exported from the UK, and must not be hoarded, because they are required for UK patients.

Key compliance points:

• Hoarding or exporting any medicine on this list is a breach of regulation 43(2) of the Human Medicines Regulations 2012 and a contravention of a wholesale dealer licence.
• MHRA may take regulatory action, including immediate suspension of a wholesale dealer licence.
• The list is updated regularly and includes both branded and generic lines.

Any contractor holding a WDA(H) or involved in export, parallel trade or significant wholesaling must ensure that procurement and sales teams are working from the current list and that systems block export or hoarding of restricted lines.

6. Dosette boxes (MDS) – contractual position, equality duties and charging (https://www.theyworkforyou.com/senedd/?id=2025-11-18.3.723488.h&s=pharmacist#g3.723469)

A recent exchange in the Welsh Senedd has restated key points about monitored dosage systems (MDS), often called dosette boxes. While this exchange happened in Wales, the impact will also be similar to contractors in England.

• Provision of dosette boxes is not part of the core NHS community pharmacy contract.
• MDS is therefore a private service. Contractors decide whether to provide it and whether to charge.
• Under the Equality Act 2010, pharmacies must make reasonable adjustments so that people with protected characteristics can access pharmacy services and take prescribed medicines safely. For some patients this may be MDS; for others, different adjustments may be more appropriate.

Charges:

• Political concern has been raised where vulnerable patients, including those on means tested benefits and disability benefits, are being charged for MDS. Examples quoted include charges of around £25 per month.
• There is wide local variation: some pharmacies provide MDS without charge for defined clinical / equality reasons; others operate a mixed model (some free, some charged); others charge all private MDS patients.

Implications for contractors:

• Have a clear, written MDS policy covering:
• Clinical and equality criteria for MDS provision
• When MDS will be provided without charge as a reasonable adjustment
• Standard private charges where applicable, and when reductions or waivers apply
• Ensure the charging structure is transparent, consistently applied and can be justified if challenged.

Make sure staff explain:

• That MDS is not an NHS funded service
• When it is being provided as a reasonable adjustment at no cost
• When and why a private fee applies, and the amount.

If you have any questions or need further support please get in touch with us as usual on

 info@pharmaplusltd.co.uk and we will be happy to assist.

Regards,

PharmaPlus