ࡱ > v y u s bjbjVV 4 < < s ~ ~ D t 0 | | |
$ [ z . | | | | | . C | | ffr
Y 0 X | | | | | | | . . | | | | | | | | | | | | | | | | ~ : A guide to reimbursement of vaccine costs (how to calculate your profit per dose)
Changes to the rules governing reimbursement of the costs associated with purchase and supply of vaccines for personal administration by GP practices, contained in the Statement of Financial Entitlements (SFE), were introduced from April 2006, following a lengthy review of dispensing by the DoH and GPC. The main impact of the changes was to reduce the profits of dispensing practices, via the introduction of a new sliding-scale for dispensing fees, and the abolition of the on-cost and container allowances.
Since then reimbursement comprises the Drug Tariff cost minus an assumed level of discount listed in a sliding financial (bandwidth) scale (see table Annex G, Part 1), based on the value of claims for reimbursement (exclusive of VAT) made for all vaccines ordered for personal administration, within a particular month. VAT on that figure plus a dispensing fee are then added to create the amount of total NHS reimbursement.
Now the first bandwidth shown in the table, which is contained in the attached extract from Schedule G to the SFE, is 0 - 2,000 per month, and shows a corresponding deduction of 3.17% from the tariff price of each vaccine. It is on this basis that we have calculated the maximum profit per dose you will be able to earn in future, as shown in the tables accompanying the Buying Group letter, utilising the discounts we have negotiated.
If, however, your claim for reimbursement during a particular month exceeds 2,000, the actual level of discount taken into account by the PPD is even higher, and will reduce still further your actual profit per dose. It is, therefore, impossible to be able to calculate with any degree of certainty the actual profit for dose you may earn, because it will vary from practice to practice and on what you claim from month to month.
One thing that is fairly obvious, is that claiming reimbursement in one go, as it were, may not be cost-effective. It may be that you will qualify for higher levels of reimbursement if you are able to spread the claims for reimbursement over several months. The credit period given to you by the vaccine companies may, therefore, become even more important, and is something you may wish to discuss with them individually.
However, we must make it clear that practices cannot transfer claims for vaccines administered during a particular month into subsequent months, as this would contravene the regulations and be viewed as fraud. The only way you can legitimately spread the reimbursement claims is if you actually spread the work, i.e. your flu clinics, over several months. The big bang approach some practices adopt whereby they try to immunise all eligible patients in a single day or over a few consecutive days, may save on administration but is likely to reduce reimbursement considerably.
As regards the dispensing fee, you will note that there is a similar sliding scale of reimbursement. When calculating maximum PPD we assume that practices will not exceed the figure of 430 items a month, which yields the highest fee of 2.19 per dose (see table Annex G Part 3) for a non-dispensing practice. Dispensing practices are, of course, more likely to exceed that number and are paid a lower rate (see table Annex G Part 2). Unlike the discount scales shown in Annex G (part 1) to the SFE, where practices figures are aggregated, the number of prescriptions used to qualify entitlement for the dispensing fee is based on the prescriptions claimed for each individual practitioner calculated separately. Consequently those practices, particularly the larger variety, who undertake large quantities of flu jabs in a particular month, face the prospect of a double-whammy, that is, a higher amount clawed back from the assumed level of discount, and a reduced level of dispensing fee as per that sliding scale. However, you may legitimately maximise your income from dispensing fees by spreading prescriptions of flu vaccines between GPs within the practice to keep each, or at least, as many as possible, below the threshold of 430 per month.
Annex G
Dispensing payments - Part 1
Discount scale (from October 2010)
Total basic price per month of the prescriptions submitted by the contractor - bandwidth New discount rate (%) 1-2,000 3.17 2,001-4,000 5.93 4,001-6,000 7.21 6,001-8000 8.06 8,001-10 000 8.68 10,001-12,000 9.19 12,001-14,000 9.60 14,001-16,000 9.97 16,001-18,000 10.29 18,001-20,00010.5720,001-22,000 10.82 22,001-24,000 11.03 24,001 and above 11.18
Annex G
Dispensing payments - Part 2
Dispensing fee scale for contractors that are authorised or required to provide dispensing services
Total prescriptions, calculated separately for each individual dispensing practitioner, in bands Prices per prescription in pence Up to 430 209.7 431-538 206.7 539-646 204.0 647-753 201.4 754-861 199.0 862-968 196.9 969-1,344 194.8 1,345-1,882 193.0 1,883-2,151 191.32,152-2,689 189.82,690-3,226 188.53,227-3,764187.43,765-4,302186.44,303 and over185.7
Annex G
Dispensing payments - Part 3
Dispensing fee scale for contractors that are not authorised or required to provide dispensing services
Total prescriptions, calculated separately for each individual practitioner, in bands Prices per prescription in pence Up to 430 218.5 431-538 215.5539-646 212.8 647-753 210.2 754-861 207.9862-968205.7 969-1,344 203.6 1,345-1,882 201.81,883-2,151 200.1 2,152-2,689 198.62,690-3,226 197.33,227-3,764 196.23,765-4,302 195.24,303 and over194.5
) Q R R
S
Z
^
z g i f s W Y H J ^
4 9 4 6 B C n u v ļ֧ &hJj hJj 5CJ OJ QJ \^J aJ hJj 5CJ OJ QJ \^J aJ hb%" hb%" hJj 6hb%" hgWW 6hJj hJj 6] hgWW hJj hJj hJj hJj 5hJj hJj 5CJ aJ hb%" 5CJ aJ 7 R S S
T
h i X Y C D E F G H I J K L M N O P gdJj $a$gdJj P Q R S T U V W X Y Z [ \ ] ^ _ ` a b c d e f g h i j k l m gdJj m n w , - 6 < i { kd $$If l U0 H B ( 0 4 4
l a ytmk7 $$If a$ gdJj $a$gdJj gdJj
v w + , - < = P Q d e w x Ｎwwpwpwpwpwpwpwpwpwpwp^ #h2F B*CJ OJ QJ ^J aJ ph hXO hJj )hXO hJj B*CJ OJ QJ ^J aJ ph 5hXO hJj 56B*CJ OJ QJ \]^J aJ ph hJj hJj hJj CJ OJ QJ ^J aJ hgWW CJ OJ QJ ^J aJ hJj 5CJ OJ QJ \^J aJ &hJj hJj 5CJ OJ QJ \^J aJ hJj hJj CJ OJ QJ ^J aJ < = J P x o $$If a$ $$If a$gdJj { kd $$If l 0 H B ( 0 4 4
l a yt2F P Q ^ d x o $$If a$ $$If a$gdJj { kdL $$If l 0 H B ( 0 4 4
l a yt2F d e q w x o $$If a$ $$If a$gdJj { kd $$If l 0 H B ( 0 4 4
l a yt2F w x x o $$If a$ $$If a$gdJj { kd $$If l 0 H B ( 0 4 4
l a yt2F x o $$If a$ $$If a$gdJj { kd> $$If l 0 H B ( 0 4 4
l a yt2F x o $$If a$ $$If a$gdJj { kd $$If l 0 H B ( 0 4 4
l a yt2F x o $$If a$ $$If a$gdJj { kd $$If l 0 H B ( 0 4 4
l a yt2F x o $$If a$ $$If a$gdJj { kd0 $$If l 0 H B ( 0 4 4
l a yt2F x o $$If a$ $$If a$gdJj { kd $$If l 0 H B ( 0 4 4
l a yt2F ( ) B C D E K L M a c j k Ѽ~hUh~hU@9 hJj hJj (hJj hJj B*CJ OJ QJ \aJ ph %hJj hJj B*CJ OJ QJ aJ ph +hJj hJj 5B*CJ OJ QJ \aJ ph %hJj 5B*CJ OJ QJ \aJ ph %hmk7 5B*CJ OJ QJ \aJ ph hmk7 5CJ OJ QJ \^J aJ hXO hJj )hXO hJj B*CJ OJ QJ ^J aJ ph hXO h2F #h2F B*CJ OJ QJ ^J aJ ph )hXO h2F B*CJ OJ QJ ^J aJ ph
x o $$If a$ $$If a$gdJj { kd| $$If l 0 H B ( 0 4 4
l a yt2F ! ( x o $$If a$ $$If a$gdJj { kd" $$If l 0 H B ( 0 4 4
l a yt2F ( ) ; B x o $$If a$ $$If a$gdJj { kd $$If l 0 H B ( 0 4 4
l a yt2F B C D M k 3 U | t t t o f f $$If a$ gdJj $a$gdJj $a$gdmk7 { kdn $$If l y 0 H B ( 0 4 4
l a yt2F 2 3 T U V ] ^ a b c d f h i j k n p r w y z { } ӼӧӼӼӕӼӼӕӼӼӧӼӼӕӼӼӕ #hmk7 B*CJ OJ QJ ^J aJ ph )hXO hJj B*CJ OJ QJ ^J aJ ph hmk7 B*CJ OJ QJ aJ ph hXO hJj %hXO hJj B*CJ OJ QJ aJ ph 1hXO hJj 56B*CJ OJ QJ \]aJ ph :U V a h } } $$If a$gdmk7 u kd $$If l U0 H o! 0 4 4
l a h i r y z q $$If a$ $$If a$gdmk7 x kd $$If l M0 H o! 0 4 4
l a ytmk7 y z z q $$If a$ $$If a$gdmk7 x kdV
$$If l E0 H o! 0 4 4
l a ytmk7 z z $$If a$gdmk7 x kd
$$If l .0 H o! 0 4 4
l a ytmk7 z q $$If a$ $$If a$gdmk7 x kd $$If l '0 H o! 0 4 4
l a ytmk7 } t $$If a$ $$If a$gdmk7 u kdK $$If l ;0 H o! 0 4 4
l a z q $$If a$ $$If a$gdmk7 x kd $$If l 0 H o! 0 4 4
l a ytmk7
! " . 4 5 A G H W ] ^ a g h ʵʵʵʵʵʧʧʧ~k %hJj 5B*CJ OJ QJ \aJ ph +hJj hJj 5B*CJ OJ QJ \aJ ph %h : 5B*CJ OJ QJ \aJ ph hXO hmk7 hXO hJj )hXO hJj B*CJ OJ QJ ^J aJ ph #hmk7 B*CJ OJ QJ ^J aJ ph %hXO hJj B*CJ OJ QJ aJ ph hmk7 B*CJ OJ QJ aJ ph ( z q $$If a$ $$If a$gdmk7 x kd
$$If l !0 H o! 0 4 4
l a ytmk7 z q $$If a$ $$If a$gdJj x kd. $$If l 0 H o! 0 4 4
l a ytmk7
z q $$If a$ $$If a$gdJj x kd $$If l 10 H o! 0 4 4
l a ytmk7
! z q $$If a$ $$If a$gdJj x kd| $$If l 0 H o! 0 4 4
l a ytmk7 ! " . 4 } t $$If a$ $$If a$gdJj u kd $$If l <0 H o! 0 4 4
l a 4 5 A G } t $$If a$ $$If a$gdJj u kd $$If l <0 H o! 0 4 4
l a G H W ] } t $$If a$ $$If a$gdJj u kd_ $$If l <0 H o! 0 4 4
l a ] ^ _ ` a i H j | w n n $$If a$ gdJj gdJj $a$gdJj u kd $$If l <0 H o! 0 4 4
l a
h i } G H i j k r t v { 쮜|i|ibiRi@ #hX% B*CJ OJ QJ ^J aJ ph hX% B*CJ OJ QJ aJ ph hXO hJj %hXO hJj B*CJ OJ QJ aJ ph 1hXO hJj 56B*CJ OJ QJ \]aJ ph hJj hJj "hJj B*CJ OJ QJ \aJ ph (hJj hJj B*CJ OJ QJ \aJ ph %hJj 5B*CJ OJ QJ \aJ ph +hJj hJj 5B*CJ OJ QJ \aJ ph %hJj hJj B*CJ OJ QJ aJ ph j k v } x o $$If a$ $$If a$gdX% { kd $$If l U0 H N! : 0 4 4
l a ytX% { } ~ + - 2 3 4 #hX% B*CJ OJ QJ ^J aJ ph %hXO hJj B*CJ OJ QJ aJ ph hX% B*CJ OJ QJ aJ ph hXO hJj )hXO hJj B*CJ OJ QJ ^J aJ ph D} ~ x o $$If a$ $$If a$gdJj { kdG $$If l 0 H N! : 0 4 4
l a ytX% x o $$If a$ $$If a$gdX% { kd $$If l 0 H N! : 0 4 4
l a ytX% x o $$If a$ $$If a$gdX% { kd $$If l 0 H N! : 0 4 4
l a ytX% x o $$If a$ $$If a$gdX% { kdK $$If l 0 H N! : 0 4 4
l a ytX% x o $$If a$ $$If a$gdX% { kd $$If l 0 H N! : 0 4 4
l a ytX% x o $$If a$ $$If a$gdX% { kd $$If l 0 H N! : 0 4 4
l a ytX% x o $$If a$ $$If a$gdX% { kdO $$If l 0 H N! : 0 4 4
l a ytX% x o $$If a$ $$If a$gdJj { kd $$If l 0 H N! : 0 4 4
l a ytX% x o $$If a$ $$If a$gdJj { kd $$If l 0 H N! : 0 4 4
l a ytX% - 3 x o $$If a$ $$If a$gdJj { kdS $$If l 0 H N! : 0 4 4
l a ytX% 3 4 A G x o $$If a$ $$If a$gdJj { kd $$If l 0 H N! : 0 4 4
l a ytX% 4 ? A F G H S U Z [ \ k q r s ʵʵʧ hJj hX% hXO hX% hXO hJj )hXO hJj B*CJ OJ QJ ^J aJ ph #hX% B*CJ OJ QJ ^J aJ ph %hXO hJj B*CJ OJ QJ aJ ph hX% B*CJ OJ QJ aJ ph G H U [ { { $$If a${ kd $$If l 0 H N! : 0 4 4
l a ytX% [ \ k q { { $$If a${ kdW $$If l 0 H N! : 0 4 4
l a ytX% q r s { kd $$If l 0 H N! : 0 4 4
l a ytX% 2 1h:p / =!"#$% $$If !v h5 B5(#v B#v(:V l U0 5 B5(/ a ytmk7 $$If !v h5 B5(#v B#v(:V l 0 5 B5(/ a yt2F $$If !v h5 B5(#v B#v(:V l 0 5 B5(/ a yt2F $$If !v h5 B5(#v B#v(:V l 0 5 B5(/ a yt2F $$If !v h5 B5(#v B#v(:V l 0 5 B5(/ a yt2F $$If !v h5 B5(#v B#v(:V l 0 5 B5(/ a yt2F $$If !v h5 B5(#v B#v(:V l 0 5 B5(/ a yt2F $$If !v h5 B5(#v B#v(:V l 0 5 B5(/ a yt2F $$If !v h5 B5(#v B#v(:V l 0 5 B5(/ a yt2F $$If !v h5 B5(#v B#v(:V l 0 5 B5(/ a yt2F $$If !v h5 B5(#v B#v(:V l 0 5 B5(/ a yt2F $$If !v h5 B5(#v B#v(:V l 0 5 B5(/ a yt2F $$If !v h5 B5(#v B#v(:V l 0 5 B5(/ a yt2F $$If !v h5 B5(#v B#v(:V l y 0 5 B5(/ a yt2F $$If !v h5 5#v #v:V l U0 5 5/ a $$If !v h5 5#v #v:V l M0 ,5 5/ a ytmk7 $$If !v h5 5#v #v:V l E0 ,5 5/ a ytmk7 $$If !v h5 5#v #v:V l .0 ,5 5/ a ytmk7 $$If !v h5 5#v #v:V l '0 ,5 5/ a ytmk7 $$If !v h5 5#v #v:V l ;0 5 5/ a $$If !v h5 5#v #v:V l 0 ,5 5/ a ytmk7 $$If !v h5 5#v #v:V l !0 5 5/ a ytmk7 $$If !v h5 5#v #v:V l 0 ,5 5/ a ytmk7 $$If !v h5 5#v #v:V l 10 ,5 5/ a ytmk7 $$If !v h5 5#v #v:V l 0 5 5/ a ytmk7 $$If !v h5 5#v #v:V l <0 , 5 5/ a $$If !v h5 5#v #v:V l <0 , 5 5/ a $$If !v h5 5#v #v:V l <0 , 5 5/ a $$If !v h5 5#v #v:V l <0 , 5 5/ a $$If !v h5 5:#v #v::V l U0 5 5:/ a ytX% $$If !v h5 5:#v #v::V l 0 ,5 5:/ a ytX% $$If !v h5 5:#v #v::V l 0 ,5 5:/ a ytX% $$If !v h5 5:#v #v::V l 0 ,5 5:/ a ytX% $$If !v h5 5:#v #v::V l 0 ,5 5:/ a ytX% $$If !v h5 5:#v #v::V l 0 ,5 5:/ a ytX% $$If !v h5 5:#v #v::V l 0 ,5 5:/ a ytX% $$If !v h5 5:#v #v::V l 0 ,5 5:/ a ytX% $$If !v h5 5:#v #v::V l 0 ,5 5:/ a ytX% $$If !v h5 5:#v #v::V l 0 ,5 5:/ a ytX% $$If !v h5 5:#v #v::V l 0 ,5 5:/ a ytX% $$If !v h5 5:#v #v::V l 0 ,5 5:/ a ytX% $$If !v h5 5:#v #v::V l 0 ,5 5:/ a ytX% $$If !v h5 5:#v #v::V l 0 ,5 5:/ a ytX% $$If !v h5 5:#v #v::V l 0 ,5 5:/ a ytX% j 6 6 6 6 6 6 6 6 6 v v v v v v v v v 6 6 6 6 6 6 > 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 h H 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 2 0 @ P ` p 2 ( 0 @ P ` p 0 @ P ` p 0 @ P ` p 0 @ P ` p 0 @ P ` p 0 @ P ` p 8 X V ~ OJ PJ QJ _HmH nH sH tH J ` J N o r m a l d CJ _HaJ mH sH tH D A D
D e f a u l t P a r a g r a p h F o n t R i@ R 0 T a b l e N o r m a l 4
l 4 a ( k (
0 N o L i s t b o b Jj D e f a u l t 7$ 8$ H$ - B*CJ OJ QJ ^J _HaJ mH ph sH tH 6 6 Jj 0 N o r m a l + 5 B* ph 6 O 6 Jj 0 N o r m a l + 6 B* ph H `"H Jj
N o S p a c i n g CJ _HaJ mH sH tH B O B Jj 0 N o r m a l + 7 B* OJ QJ ^J ph B O B Jj 0 N o r m a l + 8 B* OJ QJ ^J ph D O D Jj 0 D e f a u l t + 1 B* OJ QJ ^J ph PK ! [Content_Types].xmlj0Eжr(Iw},-j4 wP-t#bΙ{UTU^hd}㨫)*1P' ^W0)T9<l#$yi} ;~@(Hu* Dנz/0ǰ $ X3aZ,D0j~3߶b~i>3\`?/[G\!-Rk.sԻ..a濭? PK ! ֧ 6 _rels/.relsj0 }Q%v/C/} (h"O
= C?hv=Ʌ%[xp{۵_Pѣ<1H0ORBdJE4b$q_ 6LR7`0̞O,En7Lib/Se е PK ! ky theme/theme/themeManager.xml M
@}w7c(Ebˮ CAǠҟ7՛K
Y,
e.|,H ,lxɴIsQ}#Ր ֵ+!,^$j=GW)E+&
8 PK ! P theme/theme/theme1.xmlYOo6w toc'vuر-Mn iP@I}úama[إ4:l ЯGRX^6؊>$ !)O^rC$y@ /yH*)UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSe bORD۫qu gZo~ٺlAplxpT0+[}`j zA V2Fi@qv֬5\|ʜ̭NleXd sjcs7f
W+Ն7` g ȘJj|h(KD-
dXiJ؇(x$( :;˹! I_TS 1?E ??ZBΪmU/ ?~xY'y5g&/ɋ>GMGeD3Vq%'#q$8K )fw 9:ĵ
x}rxwr:\TZaG*y8IjbRc|XŻǿI
u3KGnD 1NIBs
RuK>V.E L+M2#'fi ~V vl{u8z H
* :( W ☕
~JTe\O*tHGHY }KNP*ݾ˦ TѼ9/#A7qZ $*c?qUnwN%Oi4 =3ڗP
1Pm \\9Mؓ2aD];Yt\[x]}Wr|]g-
eW
)6-rC Sj
id DЇAΜIqbJ#x꺃 6k#ASh&ʌt(Q% p%m&]caS l=X\P1Mh9MVdDAaVB[݈fJíP|8 քAV^f
Hn- "d>znNJ ة>b&2vKyϼD:,AGm\nziÙ .uχYC6OMf3or$5N HT[XF64T,ќM0E)`#5XY`פ ;%1U٥m;R>QD DcpU'&LE/pm%]8firS4d 7y\`JnίI R 3U~7+#m qBiDi*L69mY&iHE=(K&N!V.KeLDĕ{D vEꦚdeNƟe(MN9ߜR6&3(a/DUz<{ˊYȳV)9Z[4^n5!J?Q3eBoCM m<.vp IYfZY_p[=al-Y}Nc͙ŋ4vfavl'SA8|*u{-ߟ0%M07% < ҍ PK !
ѐ ' theme/theme/_rels/themeManager.xml.relsM
0wooӺ&݈Э5
6?$Q
,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{ P8g/ ]QAsم(#L[ PK- ! [Content_Types].xmlPK- ! ֧ 6 + _rels/.relsPK- ! ky theme/theme/themeManager.xmlPK- ! P theme/theme/theme1.xmlPK- !
ѐ ' theme/theme/_rels/themeManager.xml.relsPK ]
s v h { 4 s # + 4 6 B P m < P d w ( B U h y
! 4 G ] j } 3 G [ q s ! " $ % & ' ( ) * , - . / 0 1 2 3 5 7 8 9 : ; < = > ? @ A C D E L # A A @ 0 (
B
S ? 3 6 u u 9 7 b%" X% mk7 : 2F XO gWW n4Y Jj 2[ D^ s u @ 6 6 6 6 s p @ U n k n o w n G * T i m e s N e w R o m a n 5 S y m b o l 3. * A r i a l 7. { @ C a l i b r i A B C a m b r i a M a t h " h Cf{S - Y ( Y ( ! r0 h h 3 HX $P Jj 2 ! x x V a l u e d A c e r C u s t o m e r V a l u e d A c e r C u s t o m e r Oh +'0 $
D P
\ h p x Valued Acer Customer Normal Valued Acer Customer 6 Microsoft Office Word @ NSI @ ^_Җ@ er Y ՜. +,0 h p
Acer ( h Title
! " # $ % & ' ( ) * + , - . / 0 1 2 3 4 5 6 7 8 9 : ; < = > ? @ A B C D E F H I J K L M N O P Q R S T U W X Y Z [ \ ] ^ _ ` a b c d f g h i j k l n o p q r s t w x { R o o t E n t r y F Hfrz D a t a
G 1 T a b l e V W o r d D o c u m e n t
4 S u m m a r y I n f o r m a t i o n ( e D o c u m e n t S u m m a r y I n f o r m a t i o n 8 m M s o D a t a S t o r e @5frffr R U E B G V = = 2 @5frffr I t e m
P r o p e r t i e s U C o m p O b j
y
F' Microsoft Office Word 97-2003 Document
MSWordDoc Word.Document.8 9q