Pharmacy First claim period extended for IT-related delays

The new provision, to be added in Part VIC of the February 2025 Drug Tariff, applies to four pharmacy services

Pharmacy owners will be given additional time to claim for the provision of four services if IT issues, outside their control, prevent timely submissions.

Effective February 2025, this provision applies to Hypertension Case-Finding, Pharmacy Contraception Service, Pharmacy First, and Smoking Cessation Services.

Currently, claims must be submitted via the Manage Your Service (MYS) portal by the 5th of the following month, with late claims accepted only within three months of the actual submission date.

Under the new rule, pharmacy owners will have an additional twelve months (from the date by which the claim should have been submitted) to claim payment if they can provide evidence of an IT issue beyond their control that delayed the claim submission.

This new provision will be included in Part VIC of the February 2025 Drug Tariff, which will also have a clarification about de-registration from the four advanced services.

The clarification will state that pharmacy owners who de-register from providing one of these services cannot re-register for four months after their 30-day notice period ends.

Community Pharmacy England (CPE) stated that they have long been advocating for a fairer system to ensure pharmacy owners receive payment for service delivery when IT issues beyond their control have prevented them from submitting claims.

“The Department of Health and Social Care (DHSC) and NHS England have now agreed that this should be addressed and pharmacy owners will have an additional twelve months (from the date by which the claim should have been submitted) to claim payment,” the organisation said.

However, the acceptance of extended claim submission will depend on the NHSBSA investigation confirming that the IT issue was beyond the pharmacy owner's control and caused the delay in claim submission.