Top tips for endorsing Serious Shortage Protocols

Suraj Shah, PSNC Drug Tariff and reimbursement manager, offers P3pharmacy readers advice on how to deal with SSPs so that claims are submitted correctly and common pitfalls are avoided 

Leading a team that monitors medicines reimbursement and supply, what we witnessed in 2022 was a record-breaking year – and not in a good way. Thousands of pharmacy teams reported worsening supply problems, which led to growing frustration from patients unable to obtain their prescribed treatments.

The medicines supply challenges exacerbated many pricing issues and this resulted in a record number of price concessions, with PSNC now seeking a review of this broken system. To help manage some of the supply disruptions, we also saw a large increase in the number of Serious Shortage Protocols (SSPs) issued by the Department of Health and Social Care. However, I’m acutely aware that pharmacies need practical help and support now, which is where this article comes in.

SSPs were first introduced back in 2019, and PSNC recognised their value in managing medicines supply. But given their growing use, we want to make sure that claims for SSPs are being submitted correctly, so that no-one loses out on money for the work they have done.

Unfortunately, the NHS Business Services Authority (NHSBSA) has informed us that a large number SSP claims continue to be deemed invalid by the NHSBSA due to incorrect endorsements applied by PMR systems and/or pharmacy staff.

Here’s the run down of the common errors you should look to avoid and top tips to remember when claiming for supplies made in accordance with SSPs.

Five common SSP claim errors

1. Incorrect dispensed item endorsed: for SSPs that required substitution to an alternative product, the item endorsed was the same as the original prescribed item
2. Claims made against items without an active SSP: endorsement applied against items for which a valid SSP did not exist
3. Reduced quantity not endorsed: for SSPs that required a reduced quantity to be endorsed, the endorsed quantity matched the prescribed quantity
4. Claims for supplies made in accordance with an expired SSP:
   • No active SSP was in place at the time of supply – e.g. claimed after expiry of SSP
   • Dispense Notification message submitted after the period of SSP validity
   • Electronic Reimbursement Endorsement Message (EREM) or Claim Notification message submitted after the three-month claiming window (where multiple items are ordered on the same prescription)
5. Invalid or incorrect SSP reference number endorsed: the endorsed SSP number did not match the actual SSP number – e.g. SSP470 (this SSP number does not exist); SSP (blank) (missing reference number); or SSP47 (two digits instead of three).

Top five tips to endorse SSP claims correctly

1. Check the expiry date: SSPs cannot be used after the period of SSP validity has ended. Any other items on the prescription (such as an owing) can continue to be dispensed as usual, but must be submitted for payment within three months of expiry of the SSP
2. Don’t use the EPS token: EPS tokens cannot be used to make SSP claims (as payment is based on the electronic endorsement and claim message created by your PMR system)

3. Carefully review your endorsement:
   • Ensure it matches the corresponding SSP guidance on the NHSBSA website
   • Endorse the details of the alternative product(s) or quantity actually supplied (not what was originally prescribed)
   • Only endorse strength(s)/formulation(s) of products that are covered by the SSP
   • Ensure it is accurate and clear – NHSBSA processing staff must be able to determine what has been supplied

4. Review patient charge: If the patient is exempt from prescription charges, the correct exemption reason should be selected. For patients that normally pay for their prescriptions, usual charges apply, except for supplies in accordance with SSPs for a reduced quantity (no prescription charge is payable if a patient receives a smaller quantity than the quantity originally ordered) 

5. Make better use of your PMR system functionality:

• Why not check if your PMR system supports correct and complete SSP endorsements? You may need to contact your 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
• If an electronic prescription has been endorsed incorrectly, you may be able to amend it using the claim amend facility before the claim is submitted, where PMR systems allow.

For more information, see PSNC’s Top tips to claim for and reconcile SSP payments at PSNC.org.uk.

Suraj Shah is Drug Tariff and reimbursement manager at the Pharmaceutical Services Negotiating Committee (PSNC). Having worked at PSNC for five years, his main areas of responsibility relate to developments to the Drug Tariff, changes in the supply chain and supply shortages, and the review of pricing arrangements for specific categories of medicines or appliances. Suraj is a pharmacist and worked in both the hospital and community pharmacy sectors before joining PSNC.