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There are two ways in which GPs are paid for supplying drugs and appliances to patients:
• where these are supplied and personally administered to any patient by prescribing or dispensing doctors. This method is restricted to vaccines, anaesthetics, injections, diagnostic reagents, intrauterine devices, contraceptive caps and diaphragms, pessaries which are appliances, and sutures (including skin closure strips)
• where these are supplied by dispensing GPs to patients on their dispensing lists or to temporary residents in dispensing areas.
Payments for drugs and appliances include:
• the basic price less any discount calculated in accordance with the Red Book
• an on-cost allowance of a percentage of the basic price before deducting any discount
• a container allowance for each prescription
• a dispensing fee
• an allowance for VAT (payable only to GPs not registered for VAT)
• exceptional expenses as provided for in the Drug Tariff.
Payment for supplying oxygen and oxygen therapy equipment is calculated differently and is not subject to the discount arrangements.
A dispensing doctor who, with a patient's consent, issues a prescription form to enable him or her to obtain drugs or appliances from a pharmacist is not entitled to any remuneration under this part of the Red Book. If a practice provides evidence to the health authority that because of its remoteness it cannot obtain any discount on the basic price of drugs and appliances, it may exempt the practice from the discount scale. A health authority may grant exemption for up to one year, and this may be renewed if the practice is able to show that it is still experiencing difficulty in obtaining a discount.
If a practice can show that its remoteness or the small quantities of drugs and appliances it buys means that it obtains supplies at an average price at least 5% greater than the basic price, the health authority can approve a special payment to the practice at a rate in excess of the basic drug price. Details are in paragraph 44.10 of the Red Book.
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| Book Title: Making Sense of The Red Book | ||