My honourable friend the Minister of State, Department of Health (Phil Hope) has made the following Written Ministerial Statement.
As honourable Members will be aware, the department has been carrying out a review of the arrangements under part IX of the Drug Tariff for the provision of stoma and urology appliances, and related services, in primary care. This is to advise the House of the outcome of the review.
Throughout phase 2, the department’s key aims have been to:
maintain and, where applicable, improve patient care;
ensure equitable payment to dispensing appliance contractors and pharmacy contractors for the provision of equivalent services; and
achieve transparency between what is paid for services and what is reimbursed for items.
The last consultation regarding the arrangements for the provision of stoma and urology appliances, and related services, in primary care closed in September 2008; a summary of the responses is available on the department’s website at: www.dh.gov.uk/en/Consultations/ Responsestoconsultations/index.htm.
Our proposals have been amended, taking into account consultation responses. An overview of the new arrangements has been placed in the Library. In summary, the new arrangements look to:
define and standardise the services that both dispensing appliance contractors (DACs) and pharmacy contractors provide in the normal course of their business when dispensing Part IX A (catheter), Part IX B and Part IX C appliances. Essential services that must be provided include services such as a repeat prescription service, appropriate advice and a home delivery service—if the patient requests it. Advanced services, which DACs and pharmacy contractors may choose to provide, include stoma appliance customisation and appliance use reviews;
require appliance contractors to operate within a similar clinical governance framework to pharmacy contractors;
replace appliance contractor remuneration “on-cost” arrangements with fees and allowances, which will be laid out in the Drug Tariff;
introduce a funding uplift mechanism for remuneration for Part IX related services that is similar to arrangements in place within the community pharmacy contractual framework;
apply a uniform reimbursement price reduction of 2 per cent to the reimbursement prices of all items listed as of 31 March 2010 in the following sections of Part IX of the Drug Tariff:
—Part IXA catheters: urinary and urethral
—all items listed in Part IXB, which lists incontinence appliances; and
—all items listed in Part IXC, which lists stoma appliances.
allow manufacturers whose products have a combined net ingredient cost of less than £5.6 million a year to apply for an exemption from this reduction; and
introduce a reimbursement price increase mechanism for appliances supplied six months after the new arrangements come into effect.
To allow these new arrangements to be implemented, amendment regulations will be laid—and amendment directions made—at least six months before they come into force.
Subject to this, the new arrangements will be implemented from 1 April 2010.
In addition to the new arrangements, the department has decided that there will be a 4.4 per cent uniform increase on the current on-cost percentage paid to DACs for a six-month period from October 2009 to March 2010. The increase recognises that, as the reimbursement price increase mechanism has been suspended since April 2006, the on-cost that DACs currently receive by way of remuneration for service provision, which is linked to reimbursement , has only increased in line with related volume increases over the same period.