Dumfries & Galloway Health Board
Prescribing Support Team

Pay and Report Guidance

Posted: 1 Aug 13 Edited: 13 Aug 18
ADTC Forms Miscellaneous

‘Pay and Report’ covers all products where it is not clear whether or not the product in question should be classified as a drug.

‘Pay and Report’ prescribed items NHS Dumfries and Galloway guidance ‘Pay and Report’ covers all products where it is not clear whether or not the product in question should be classified as a drug. As such, the dispensing pharmacist (or doctor) will be paid for the supply but the health board can reclaim cost of the item from the remuneration of the prescriber. GPs who prescribe ‘Pay and Report’ items will be asked to justify such prescriptions before a decision is reached. ‘Pay and Report’ normally applies to the following groups of products:- 1. Foods or food supplements not included in the Advisory Committee on Borderline Substances (ACBS) list Some food products are prescribable under ACBS rules, but only for specific indications, as outlined in Appendix 2 of the BNF 2. Cosmetic products not included in the BNF or ACBS list Only products listed in the BNF have a medical product license and are prescribable 3. Herbal products/remedies not licensed as medicine Although there may be limited evidence of efficacy, products are not standardised and therefore not subject to the same restrictions on quality, safety and efficacy as licensed medicinal products. Until the manufacturers choose to apply for licensing as medicines, these products are considered to be food supplements and are not suitable for prescribing on the NHS Products classified as ‘Pay and Report’ should not normally be prescribed in Primary Care as they are not considered to be Medicine. These items will be classified into one of three categories 1. Category 1: these items will be allowed and can be prescribed 2. Category 2: these items will be allowed on the first occasion (and on up to 2 subsequent occasions*) but further prescriptions will be disallowed and the cost reclaimed. The item will then become a Category 3 item 3. Category 3: these items will not be allowed and the cost reclaimed A preliminary list has been agreed with the GP sub-committee (appendix 1) *due to prescription data being three months in arrears PROCESS FOR DEALING WITH 'PAY and REPORT' ITEMS FROM THE PPD 1. Details of ‘Pay and Report’ items are e-mailed to the Health Board, on a monthly basis, for further investigation. Prescribers will be notified if it is NOT category 1 (or does not appear on the list in appendix 1) and asked to justify the prescription 2. GP sub-committee will be asked for an opinion as to the classification of the item (except if Category 1), taking into account the justification for the prescription 3. Prescribers will be informed of the classification 4. If classified as Category 1, there will be no further action 5. If classified as Category 2 or 3, the prescriber will be informed a. If classified as Category 2 it will be allowed for this occasion but will become Category 3 and further prescriptions disallowed (2 subsequent monthly prescriptions will be allowed due to the 3 month delay in processing prescribing data, for this period only. Any further prescriptions (for any patient) will be disallowed). If prescriptions are written for other patients before the prescriber has been informed of the Category 2 classification, but within one month from the date the prescriber has been informed, they will be allowed b. If classified as Category 3, it will be disallowed and the cost of the item reclaimed by the health board (with the 3 month window as above)  Appendix 1 Pay and Report – Feedback from GP Sub Committee – 16th May 2013 It is suggested that 'Pay and Report' items be classified in three categories: 1, 2, and 3. Category 1 items can be regarded as drugs and may be prescribed; category 2, where the item is allowed on this occasion but is inappropriate to continue; and category 3, where the prescription is disallowed (or where the prescriber has previously been advised of category II item). The list will be updated regularly and distributed to prescribers Examples of Pay and Report items are as follows: Category 1 (this list may expand over time) JUVELA PURE OATS 500G LUBORANT SPRAY 60ML MAGNAPHATE TABS MAGNESIUM GLYCEROPHOSPHATE TABS 97.2MG OILATUM BATH FORMULA SODIUM CHLORIDE EYE DROPS 5% Category 2 (this list will be transient, with items being reclassified as Category 3) ASCORBIC ACID TABS EFF 1G Category 3 (this list will expand over time) A-CYS CAPSULES 600MG APTAMIL COMFORT PDR 900G AROVIT ORAL DROPS 150000 UNITS AVEENO SKIN RELIEF MOISTURISING LOTION BARKET GF ORGANIC PORRIDGE FLAKES BEPANTHEN NAPPY CARE OINTMENT 5% BLEPHASOL LOTION CLINISAN EMOLLIENT WASH CREAM COD LIVER OIL CAPS 500MG COMFORT FIRST POWDER DERMACOOL CREAM 1% E45 JUNIOR FOAMING BATH MILK EUCERIN DRY SKIN RELIEF FACE CREAM FREEMANS HOMEOPATHIC GLUCOJUICE LIQUID GLUCOTABS ICAPS JUVELA SPECIAL FLAKES NUMARK COD LIVER OIL CAPS 1G OCUVITE OMNEO COMFORT POWDER PERNATON GREEN LIPPED MUSSEL EXTRACT GEL SENSET SKIN CLEANSING FOAM SEVEN SEAS CRANBERRY SEAS 200MG FORTE STELLISEPT MED SKIN CLEANSER VERNAGEL 6G SACHET VISIONACE TABS This list is not exhaustive and will evolve over time.