Emergency Supply Services

For the last two years we have had an NHSE locally commissioned emergency supply service.  This service will continue in 2017-18 with some changes which are outlined  below.  In addition there has been a new national pilot advanced service introduced, this is known as the NUMSAS service and it is expected that this service will go live in our area in April, in time for Easter again you can find more information below.  In addition there is a dedicated page on this website for each service so that you can access SLAs etc

The following information aims to answer your questions on both the new service, the changes to the local service and about how the two will work side by side.  You can download this document as a PDF for printing if you prefer.

NHS Urgent Medicine Supply Advanced Supply Service Pilot (NUMSAS) and Locally Commissioned Emergency Supply Service (local service).  FAQs

What is NUMSAS?

 NUMSAS is an NHS Advanced Service in the Community Pharmacy Contractual Framework which is being launched as a national pilot.  NHS 111 refer patients to Pharmacies to receive an emergency supply of medication if appropriate.


Is it compulsory for my pharmacy to provide this service?

No. NUMSAS contractors can choose whether they wish to provide this service.


Why is it a pilot service?

 Pharmacy Emergency Supply Services have historically been commissioned locally to reduce pressure on GPs and OOH services.  Evaluation of locally commissioned services in parts of the UK have identified that 80% of callers to NHS111 could be supplied with meds directly from the pharmacy without need for an appointment for a prescription.  Only 2% of callers required a prescription from a GP.

NHSE have introduced the service as a pilot to assess if it will work nationally and to test the referral processes.  Should this prove successful it could become an ongoing national advanced service.


Should I get involved?

 This is the first time there has been a national referral scheme involving pharmacy. Taken with Summary Care Record access, pharmacists are now in a better position to become part of other treatment pathways.

The LPC believe it is important to show the NHS that we can deliver this service over a wide geography and to a high standard.  By doing this we demonstrate we are able to deal with NHS referrals to deliver fully integrated NHS services leading to better outcomes for patients.


Is this instead of the local service we already offer?

 No. NHSE Shropshire and Staffordshire (NHSES&S) see the local and national services as complementing each other, it is about increasing access and NHSE will be running NUMSAS in addition to the local service.

The local service is changing from April 1st 2017 and you will find more information at the end of these FAQs.  One major change is that the local service will be available 24/7 to bring it in line with the terms of the NUMSAS service.


If I run both the local scheme and the NUMSAS which do I offer the patient?

A decision has been made by NHSES&S that once the NUMSAS service goes live in our area, then NHS111 will no longer be able to refer patients in to our local scheme.  Therefore, if NHS111 has referred a patient to you, it is for NUMSAS.  You will receive an email referral to your NHS mail address and you MUST use the NUMSAS scheme to supply medication to that patient.

If the patient accesses an emergency supply by any route other than via NHS111 then you may supply medication using the local scheme.


When does NUMSAS start?

 The aim is to go live by Friday 7th April.  Nationally NHSE have made the decision to start NUMSAS in our area before Easter.

The service will only be switched on locally if the NHSES&S team are confident that the pharmacies and the systems are in a position to run the service.


Why do I need a pharmacy NHS Email account?

Pharmacies providing the NUMSAS service need to have an NHS mail account as patient identifiable information will be sent by email. The NHS is putting much more resource into ensuring participating pharmacies have an email address on time. When NHS 111 refer a patient to a pharmacy for NUMSAS it can ONLY be by email to a pharmacy NHS mail address.


I applied for my NHS mail account, what happens next?

 The number of pharmacies requesting NHS mail addresses is huge and so a prioritisation process has been put in place.

The process is different for pharmacies who applied individually for NHS mail and for multiples / groups where an application was submitted centrally for all branches.  Please see appropriate answer below:


I am an individual pharmacy which made an NHS mail application, how do I sign up to provide NUMSAS?

The central NHSE team are supplying our local NHSE team with lists of pharmacies who have applied for NHS mail addresses.  NHSES&S are then emailing the pharmacy confirming they have applied for NHS mail and asking if they are intending to offer the NUMSAS service.

If you click on the link in the email from NHSES&S, this will take you to the NHS BSA website and you will confirm your intention to deliver NUMSAS.  Your NHS mail request will then be put on the priority list.

It is therefore important that you follow the instructions in the email from NHSES&S so that you can have your NHS mail address in time to deliver the service when it starts in April

The LPC cannot provide the link as NHSES&S have to keep a record of who this has been sent to in order to report back to NHSE central team about NUMSAS progress.

NB: If you are not going to deliver NUMSAS your NHS mail account will be provided in the following wave.


I am part of a multiple / small group which made an NHS mail application on behalf of my branch, how do I sign up to provide NUMSAS?

For many multiples and groups your head office will have applied for your NHS mail address and is also letting NHSE central know which branches it wishes to sign up to NUMSAS you need to follow the procedure outlined by your head office team.  Locally the NHSES&S team do not receive lists of the groups who have made a multiple application but we have been informed by NHSES&S that individual branches do need to inform NHS BSA.  It is important that you know what your company want you to do so we suggest you contact your area manager, head office or superintendent’s office for clarification.


 What information do I need to sign up with the NHS BSA website?

 The electronic form on the NHS BSA website asks for the Pharmacy Organisation Code; this is the ODS or F code for the pharmacy that is used on the end of month submission to the Pricing Authority. If the form is incorrectly completed it may result in non-payment for the service.


How does the NUMSAS scheme work?

Full details of the service spec can be found HERE.  Patient contacts NHS111 and says they have run out of medicine, NHS111 agree with them a convenient pharmacy and email the details of the referral to the pharmacy. The patient is told they need to ring the pharmacy to arrange a time to attend and have a consultation with the pharmacist.

If the pharmacist considers the supply to be appropriate they supply the medication as per the terms of the service spec while making all the necessary legal records.  The pharmacy must also generate an emergency supply record form (see PharmOutcomes info below).


Do I have to offer the service over all of my opening hours?

 Yes.  When you sign up to offer NUMSAS you are committing to offering the service during your core and supplementary hours.  Locum pharmacists are expected to deliver the service in your absence and you must ensure they understand how the service operates.


My pharmacy doesn’t have a consultation room; can I provide the service?

No. Having a consultation room is a prerequisite for provision of the NUMSAS.


Can I refer the patient back to NHS111 for any reason?

 Patients should NOT be referred back to NHS111, this service is about pharmacists dealing with a referral from NHS111 and where necessary referring the patient onwards to another healthcare professional.


What happens if NHS111 refers a patient for a CD?

 You cannot give a Controlled drug on the NUMSAS and so you must contact the out of hours (OOH) to arrange a referral for the patient. It is hoped you will have access to special phone numbers if you need to refer a NUMSAS patient to OOH.   You must NOT refer the patient back to NHS111


Can I use special OOH phone number which has been made available to me as a NUMSAS pharmacy for a patient who is not part of NUMSAS or for any other query?

No, this number has been made available for the small number of patients who need onward referral, eg for an urgent CD.


What happens if I do not have the drug in stock that the patient requires

If you do not have the required medicines in stock you will need to find the nearest NUMSAS pharmacy and contact them to ensure they have stock, then refer the patient to them.  PharmOutcomes can be used to locate other NUMSAS pharmacies.

Advice will follow about how to forward the referral email on to the pharmacy which is actually going to make the supply.

If you have followed this procedure you will be able to claim the consultation and admin fees for delivering the service.  The 2nd pharmacy will also be paid a consultation and admin fee plus the supply fee(s) and cost of medication (DM+D with VAT at appropriate rate).


 What happens if the patient is referred from NHS111 and I discover they have a valid electronic prescription in the system and I supply against that?

 You would dispense the electronic prescription and claim the relevant medication cost and dispensing fees in the normal way.  HOWEVER, in addition you would also be able to claim the NUMSAS consultation and admin fees as you have managed the NHS111 referral in addition to dispensing an electronic prescription (see info below on PharmOutcomes)

How do I claim payment for NUMSAS provision?

 Claims to be submitted to NHS BSA by the 5th day of the month (See info on PharmOutcomes below).

For each patient the pharmacy sees they must complete an FP10DT EPS dispensing token detailing the outcome of the interaction as well as details of medication supplied.

A monthly summary must also be submitted using the NUMSAS claim form, this must be submitted with the NUMSAS FP10 EPS dispensing tokens.


Can we submit the NHS Urgent Medicine Supply Advanced Service Claim submission form as part of the monthly prescription bundle?

 No. This process will be separate to the submission of other FP10 forms and the form needs to be sent to a different address.


Can I use PharmOutcomes for NUMSAS?

 PharmOutcomes is available in Staffordshire and Shropshire and we strongly recommend you use it.  This is because PharmOutcomes simplifies the process for you and in addition the local NHS England team and/or the LPC will be able to access local data to monitor uptake of the service.


How do I get started on PharmOutcomes?

 The NUMSAS modules will be available to all of our pharmacies on the locally agreed NUMSAS “go-live” date.

You will be asked to complete a pharmacy registration module – this will ask about your IG Toolkit, consulting room, pharmacy NHS mail etc.

Each pharmacist will be asked to complete an enrolment module the first time they access the patient modules.

Both of these actions are to be completed one time only, after that you will have access to the modules and functionality outlined in the next question.


What can PharmOutcomes do with regards to NUMSAS?

  1.  Patient registration module which should be completed for new patients.
  2. Patient supply module – linked to the registration module (previous supplies you have made to this patient under NUMSAS will be visible in the top left of your screen)
  3. GP notifications – this will be done automatically to the GP practice NHS mail address. Where no NHS mail address is available the system will warn you to print out the notification which should then be sent to the practice by a different, secure route.
  4. If you do not have the medication you will be able to search for the nearest NUMSAS pharmacy to aid you in onward referral
  5. Printing FP10DT EPS dispensing token for each patient – simply tell PharmOutcomes which printer to use and it will print out the token for you, this is on both halves of the token. Tear in half and the left side is sent to NHS BSA at month end, the right side can be retained in your pharmacy as a record of provision.
  6. Printing NUMSAS claim form – this can be done monthly, information will be populated into the form using data from the supplies you have made during the month. Print this out and send off with your tokens to claim the NUMSAS fees each month.


What happens if, in the future, I decide to stop running the service?

 You must inform the BSA. However, please also inform the local NHSE area team and your LPC.


The local emergency supply service spec runs out at the end of March, what is happening with that?

The new SLA for the local emergency supply service is being finalised, it has not been possible to send it out sooner due to uncertainties around how the local service and NUMSAS will work together.  You should receive the new version of the local service SLA soon and we urge you to sign and return that to NHSE locally (england.pharmacy-westmidlands@nhs.net) as soon as possible to ensure that you stay on the lists circulated to CCGs, OOH providers etc.


Will NHS111 still refer patients to pharmacies offering the local service?

 No, NHS111 will only refer patients to NUMSAS pharmacies.


How can patients access the local emergency supply service under the new SLA?

 The other original routes into the service remain in place except that the NHS111 referral route has been removed from the local service in the new SLA.


Can I offer the local service when the patient’s GP practice is open?

 Yes, you can use your professional discretion to supply emergency medication even when the surgery is open.  This change has been introduced so the local service is available for the same hours as the nationally commissioned NUMSAS service.


Do I have to offer the local service over all of my opening hours?

Yes.  When you sign up to offer the local emergency supply service you are committing to offering the service during your core and supplementary hours.  Locum pharmacists are expected to deliver the service in your absence and you must ensure they understand how the service operates.


How do I sign up for the local emergency supply service under the new SLA?

 Pharmacies will shortly be receiving the new SLA which comes into force at the end of March 2017 and in order to offer the local service you will be required to sign the SLA and return a copy of the signature page to NHSE at england.pharmacy-westmidlands@nhs.net


I already offer the local emergency supply service, do I have to sign and return this new SLA?

You must sign and return this even if you are currently offering the local emergency supply service as sign up is on an annual basis.


I work for a multiple, do I need to sign up to NUMSAS and/or the local service?

Please be aware that the multiples are doing central sign-ups for pharmacy services and branches often do not have the authority to sign an SLA on behalf of the company.

There are two things you could do:

Check that your services manager, area manager or superintendent have had a copy of the SLA so that the sign-up process can be followed.

Find out if you have been signed up to provide a service as we are keen to avoid the situation where head office have signed you up and you are unaware and turn patients away.