Following the announcement of thirteen HRT Serious Shortage Protocols (SSP), PSNC has been working with NHS Business Services Authority (NHSBSA) to understand whether claims for HRT SSPs are being submitted correctly and in accordance with the specific supporting guidance for each SSP.
Between 1 April 2022 and 31 May 2022, NHSBSA received several electronic EPS SSP claims which did not meet the requirements for a valid SSP .
The reasons for these incorrect/invalid SSP claims were due to:
- Reduced quantity not endorsed – for SSPs that require a reduced quantity to be endorsed, often the endorsed quantity matched the prescribed quantity. Majority of invalid SSP claims were due to this reason.
- Incorrect item endorsed – for SSPs that require substitution to an alternative product, the endorsed item was almost always the same as original prescribed item.
- Claims made against items without an active SSP – SSP endorsed against items for which a valid SSP did not exist.
- Claims for supplies made in accordance with an expired SSP:
- No active SSP in place at the time of supply – i.e., SSP claimed for items on prescriptions issued after SSP expired.
- Alternative item correctly supplied during the period of SSP validity, but Dispense Notification message submitted after the period of SSP validity.
- Alternative item correctly supplied during the period of SSP validity and the Dispense Notification message submitted during the period of SSP validity but the EREM or Claim Notification message submitted after the 3-month claiming window.
- Invalid or incorrect SSP reference number endorsed – For example SSP 000, SSP (missing reference number), SSP 028 (incorrect number), SSP 28 (two instead of three digits).
For any invalid SSP claims, contractors will continue to receive the usual dispensing fee but will not receive any SSP fee (£5.35). Reimbursement for invalid SSP claims will also be in accordance with the prescribed product rather than the alternative product or quantity supplied in accordance with an SSP.
To ensure correct payments for SSP claims are received, contractors should follow the endorsement requirements outlined in the specific supporting guidance for each SSP. Contractors are strongly advised to check that their PMR systems supports correct and complete SSP endorsements. If there is any doubt on the correct use of the PMR system SSP functionality, contractors should contact their system supplier for further guidance. Any suggestions about how system usability and functionality could be improved should also be fed back to the system supplier.
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